%0 Journal Article
%T The Gap in the Current Research on the Link between Health Locus of Control and Multiple Sclerosis: Lessons and Insights from a Systematic Review
%A Nicola Luigi Bragazzi
%J Multiple Sclerosis International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/972471
%X Multiple sclerosis (MS) is a chronic neurological disease whose etiology has not been fully understood yet in detail. Empirical findings show how psychosocial symptoms are very important features of the clinical presentation of MS, having a deep impact on patient's quality of life, and thus psychological coping strategies may play a central role in reducing the burden of the disease and improving patient's satisfaction of life. MS progression and relapses/exacerbations are unpredictable and may depend on factors such as stressor chronicity, frequency, severity, type, and individual patient characteristics such as depression, personality, locus of control (LOC), optimism, and perceived social support. Due to its importance for health-care delivery, rehabilitation, and nursing, here, we make a systematic review on the current state-of-the-art studies concerning the relationship between LOC and MS, according to the PRISMA guidelines, and we assess the quality and the completeness of the studies using the CONSORT instrument, underpinning their limitations, and suggesting how to fill the gap in this research field. 1. Introduction 1.1. Multiple Sclerosis Multiple sclerosis (MS) is a chronic autoimmune inflammatory progressive neurological disorder resulting in injury of the oligodendrocytes and in axonal demyelination [1]. There are at least 2¨C2.5 million patients worldwide suffering from MS, and its prevalence is unevenly distributed and highly variable from less than 5 cases per 100,000 inhabitants up to more than 100¨C200 cases per 100,000 inhabitants [2]. It is more likely to affect women than men with a ratio of 2.3 which has gradually increased over time, and the age of onset is generally young adulthood, usually affecting people in their 20s or 30s [3], even though pediatric and late onset as well as clinical variants have been reported. The progress of the disease is extremely variable and unpredictable, the etiology is unclear, there is currently no cure, and only symptomatic therapy is available [1]. 1.2. The Psychosocial Burden Psychosocial symptoms are very important clinical features of the presentation of MS, having a deep impact on patient¡¯s quality of life [4], thus suggesting an integrated biopsychosocial approach [5, 6] to the disease, as also strongly recommended by the American MS task force [7]. Psychological symptoms include above all depression [8], with a rather high prevalence around 50%, as reported by the recent large-scale study of anxiety and depression prevalence in people with MS in the UK [9]. Depression is more common during
%U http://www.hindawi.com/journals/msi/2013/972471/