Skip to main content

Advertisement

SpringerLink
Log in

The Influence of Loneliness and Anxiety Levels on MG-Specific Quality of Life in Patients with Myasthenia Gravis during the COVID-19 Pandemic

  • Special Issue: Social Isolation and Loneliness in Acute and Chronic Illness
  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Myasthenia gravis (MG) is one of the most common autoimmune diseases and can occur at any age. The study aimed to evaluate the influence of loneliness and anxiety levels on MG-specific quality of life in patients with myasthenia gravis during the COVID-19.

Methods

This was a cross sectional study and the population consisted of patients with MG throughout Turkey between August 1 and October 31, 2021. The study was completed with 149 patients who met the inclusion criteria and agreed to participate in the research.

Results

The mean MG-specific quality of life score was 44.15 ± 13.77, the mean UCLA loneliness scale was 56.13 ± 11.55, and the mean Beck Anxiety Inventory score was 24.63 ± 13.78. There was a moderately positive linear relationship between the participants’ MG-specific quality of life (r = 0.589; p < 0.001) and the Beck Anxiety Inventory, and there was a weak negative linear relationship with the UCLA loneliness scale (r = 0.323; p < 0.001). The variables affecting the MG-specific quality of life were the following: anxiety, loneliness, employment status, income level, symptom levels, and having another chronic disease; a multiple regression model was created with these variables, and it was observed that anxiety and loneliness affected participants' MG-specific quality of life. The variables in the model explained 52.9% of the MG-specific quality of life, and the model was statistically significant (p < 0.001).

Conclusion

The study determined that the participants had intense loneliness, moderate anxiety, and a moderate MG-specific quality of life. The participants' MG-specific quality of life has decreased as their anxiety has increased, and the participants’ MG-specific quality of life has increased as their loneliness has increased.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

The data that support the findings of this study are available on request from the corresponding author.

References

  1. Koneczny I, Herbst R. Myasthenia gravis: pathogenic effects of autoantibodies on neuromuscular architecture. Cells. 2019;8(7):671.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Özel F, Altunkan AA, Azizoğlu M. Postoperative respiratory failure in a patient with undiagnosed myastenia gravis. Turk J Anaesthesiol Reanim. 2016;44(2):108–10.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Braz NFT, Rocha NP, Vieira ÉLM, Barbosa IG, Gomez RS, Kakehasi AM, Teixeira AL. Muscle strength and psychiatric symptoms influence health-related quality of life in patients with myasthenia gravis. J Clin Neurosci. 2018;50:41–4.

    Article  PubMed  Google Scholar 

  4. Díaz-Maroto I, García-García J, Sánchez-Ayaso PA, Alcahut-Rodríguez C, González-Villar E, Pardal-Fernández JM, Segura T. (2020). Ocular myasthenia gravis and risk factors for developing a secondary generalization: Description of a Spanish series. Neurology (Engl Ed) 15, S0213–4853(20)30300–5.

  5. Guo RJ, Gao T, Ruan Z, Zhou HY, Gao F, Xu Q, Yu LP, Wu SD, Lei T, Li HH, Sun C, Zhang M, Gao YW, Lu XD, Tang YL, Tang BL, Huo FY, Zhu Y, Li ZY, Chang T. Risk factors for generalization in patients with ocular myasthenia gravis: a multicenter retrospective cohort study. Neurol Ther. 2022;11(1):73–86.

    Article  PubMed  Google Scholar 

  6. Hehir MK, Silvestri NJ. Generalized Myasthenia Gravis: Classification, Clinical Presentation, Natural History, and Epidemiology. Neurol Clin. 2018;36(2):253–60.

    Article  PubMed  Google Scholar 

  7. Cioncoloni D, Casali S, Ginanneschi F, Carone M, Veronica B, Rossi A, Giannini F. Neurol Major motor-functional determinants associated with poor self-reported health-related quality of life in myasthenia gravis patients. Sci. 2016;37(5):717–23.

    Google Scholar 

  8. Frost A, Svendsen ML, Rahbek J, Stapelfeldt CM, Nielsen CV, Lund T. Labour market participation and sick leave among patients diagnosed with myasthenia gravis in Denmark 1997–2011: a Danish nationwide cohort study. BMC Neurol. 2016;16(1):224.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Nagane Y, Murai H, Imai T, Yamamoto D, Tsuda E, Minami N, Suzuki Y, Kanai T, Uzawa A, Kawaguchi N, Masuda M, Konno S, Suzuki H, Aoki M, Utsugisawa K. Social disadvantages associated with myasthenia gravis and its treatment: a multicentre cross-sectional study. BMJ Open. 2017;7(2): e013278.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jeong A, Min JH, Kang YK, Kim J, Choi M, Seok JM, Kim BJ. PLoS ONE. 2018;13(11):e0206754.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Masythenia Gravis Found of America. 2022. https://myasthenia.org/MG-Community/Managing-Your-MG.

  12. Ambrosio L, Senosiain GJM, Riverol Fernández M, Anaut BS, De Cerio D, Ayesa S, Ursúa SME, Caparrós N, Portillo MC. Living with chronic illness in adults: a concept analysis. J Clin Nurs. 2015;24(17–18):2357–67.

    Article  PubMed  Google Scholar 

  13. Stojanov A, Stojanov J, Milosevic V, Malobabic M, Stanojevic G, Stevic M, Djordjevic G. The Impact of the Coronavirus Disease-2019 Pandemic on the Psychological Status and Quality of Life of Myasthenia Gravis Patients. Ann Indian Acad Neurol. 2020;23(4):510–4.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Li Y, Emmett CD, Cobbaert M, Sanders DB, Juel VC, Hobson-Webb LD, Massey JM, Gable KL, Raja SM, Gonzalez NL, Guptill JT. Knowledge and perceptions of the COVID-19 pandemic among patients with myasthenia gravis. Muscle Nerve. 2021;63(3):357–64.

    Article  CAS  PubMed  Google Scholar 

  15. Law C, Flaherty CV, Bandyopadhyay S. Cureus. A Review of Psychiatric Comorbidity in Myasthenia Gravis. 2020;12(7): e9184.

    Google Scholar 

  16. Aysal F, Karamustafalioğlu O, Özçelik B, Yilmaz M, Karamustafalioğlu N, Yumrukçal H, Tankaya O. The Relationship of Symptoms of Anxiety and Depression with Disease Severity and Treatment Modality in Myasthenia Gravis: A Cross-sectional Study. Noro Psikiyatr Ars. 2013;50(4):295–300.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Jordan H, Ortiz N. Management of Insomnia and Anxiety in Myasthenia Gravis. J Neuropsychiatry Clin Neurosci. 2019;31(4):386–91.

    Article  PubMed  Google Scholar 

  18. Boldingh MI, Dekker L, Maniaol AH, et al. An up-date on specific quality of life in myasthenia gravis -results from population-based cohorts. Health Qual Life Outcomes. 2015;13:115.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Blum S, Lee D, Gillis D, et al. Clinical features, and impact of myasthenia gravis disease in Australian patients. J Clin Neurosci. 2015;22:1164–9.

    Article  PubMed  Google Scholar 

  20. Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, Agha M. Agha R The socio-economic implications of the coronavirus pandemic (COVID-19): A review. Int J Surg. 2020;78:185–93.

    Article  PubMed  PubMed Central  Google Scholar 

  21. International MG/COVID-19 Working Group, Jacob S, Muppidi S, Guidon A, Guptill J, Hehir M, Howard JF Jr, Illa I, Mantegazza R, Murai H, Utsugisawa K, Vissing J, Wiendl H, Nowak RJ.Guidance for the management of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) during the COVID-19 pandemic. J Neurol Sci. 2020;412:116803.

  22. Stojanov A, Milošević V, Đorđević G, Stojanov J. Quality of life of myasthenia gravis patients in regard to epidemiological and clinical characteristics of the disease. Neurologist. 2019;24(4):115–20.

    Article  PubMed  Google Scholar 

  23. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56:893–7.

    Article  CAS  PubMed  Google Scholar 

  24. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the beck anxiety inventory: psychometric properties. J Cogn Psychother. 1998;12:163–72.

    Google Scholar 

  25. Russell D, Peplau LA, Ferguson ML. Developing a measure of loneliness. J Pers Assess. 1978;42:290e294.

  26. Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980;39(3):472–80.

    Article  CAS  PubMed  Google Scholar 

  27. Demir A. Validity and reliability of the UCLA Loneliness Scale. J Psychol. 1989;7(23):14–8.

    Google Scholar 

  28. Mullins LL, Carpentier MY, Paul RH, Sanders DB. Disease-specificmeasure of quality of life for myasthenia gravis. Muscle Nerve. 2008;38:947–56.

    Article  PubMed  Google Scholar 

  29. Burns TM, Conaway MR, Cutter GR, Sanders DB. Muscle Study Group. Less is more, or almost as much: a 15-item quality-of-life instrument for myasthenia gravis. Muscle Nerve 2008;38(2):57–63.

  30. Taşcilar NF, Saraçli Ö, Kurçer MA, Ankarali H, Emre U. Reliability and validity of the Turkish version of myasthenia gravis-quality of life questionnaire-15 item. Turk J Med Sci. 2016;46(4):1107–13.

    Article  PubMed  Google Scholar 

  31. Yu L, Qiu L, Ran H, Ma Q, Lu YR, Liu WB. Studying the relationship between clinical features and mental health among late-onset myasthenia gravis patients. World J Psychiatry. 2022;12(3):470–82.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hwang TJ, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020;32(10):1217–20.

    Article  PubMed  Google Scholar 

  33. Boursier V, Gioia F, Musetti A, Schimmenti A. Facing loneliness and anxiety during the covıd-19 isolation: the role of excessive social media use in a sample of Italian adults. Front Psychiatry. 2020;11:586222.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Galassi G, Marchioni A. Myasthenia gravis at the crossroad of COVID-19: focus on immunological and respiratory interplay. Acta Neurol Belg. 2021;121(3):633–42.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Jacob S, Kapadia R, Soule T, Luo H, Schellenberg KL, Douville RN, Pfeffer G. Neuromuscular complications of sars-cov-2 and other viral infections. Front Neurol. 2022;13:914411.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sakallı-Uğurlu N, Türkoğlu B, ve Kuzlak A. How are women and man perceived? Structure of gender stereotypes in contemporary Turkey. Nesne J Psychol. 2018;6(13):309-336.

  37. World Health Organization, 2022. http://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide

Download references

Author information

Authors and Affiliations

  1. Nursing Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey

    Pınar Yeşil Demirci, Saliha Bozdoğan Yeşilot & Zehra Eskimez

Authors
  1. Pınar Yeşil Demirci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saliha Bozdoğan Yeşilot
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zehra Eskimez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pınar Yeşil Demirci.

Ethics declarations

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Demirci, P.Y., Yeşilot, S.B. & Eskimez, Z. The Influence of Loneliness and Anxiety Levels on MG-Specific Quality of Life in Patients with Myasthenia Gravis during the COVID-19 Pandemic. Int.J. Behav. Med. 31, 414–421 (2024). https://doi.org/10.1007/s12529-023-10234-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-023-10234-6

Keywords

Search

Navigation