The Mediating Role of Illness Perception in the Association Between Psychological Distress and Symptom Reporting in Early-Stage Multiple Sclerosis Patients

Objective To assess the association between psychological distress and self-reported multiple sclerosis (MS) symptom severity, and to determine whether illness perceptions mediates this relationship in patients recently diagnosed with relapsing remitting MS (RRMS). Methods We conducted a multicenter, non-interventional study including RRMS adult patients (disease duration of ≤18 months) residing in Spain. Participants completed self-reported measures on demographics, MS symptoms (SyMS), mental health (Hospital Anxiety and Depression Scale, HADS), and perceptions of their RRMS (Brief Illness Perception Questionnaire, B-IPQ). Results A total of 189 participants were included [mean age (SD) of 36.6 (9.4) years and 70.6% female]. Linear regression analysis revealed a significant relationship between HADS and SyMS ( β = 0.661, 95%CI: 0.77,1.07; p<.001). The mediation analysis revealed that illness perception significantly and partially mediated the relationship between HADS and SyMS ( β = 0.138, p<.001, 95% CI: 0.07, 0.20). These findings remained consistent following the adjustment for other clinical and radiological measures. Conclusion Psychological distress and a more negative illness perception are primary factors associated with greater self-reported MS symptom burden in recently diagnosed RRMS patients. Interventions targeting illness perception may help mitigate the impact of psychological distress on patient-reported MS outcomes.