A variety of psychological reactions have been observed in multiple sclerosis (MS), with depressive symptoms and alterations in self-concept among the most prominent. In a pilot study (n = 53) followed by two waves of a prospective study (n = 94, n = 66), structured interviews were used to examine the relationship between disease characteristics and psychological status in a sample of MS outpatients. Depressive symptoms were common but severe depressive illness was rare. Patients who were more neurologically impaired and more disabled in activities of daily living reported a more negative self-concept but did not report higher levels of depressive symptoms, demoralization, or negative affect balance. In contrast, patients reporting an exacerbation at the time of the interview tended to report a more negative self-concept, higher levels of demoralization, and a more negative affect-balance. The implications of these findings for psychological assessment and treatment are discussed.
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