# The role of fear of relapse in quality of life among patients with relapsing–remitting multiple sclerosis

## TL;DR

This study explores how fear of relapse and health anxiety affect quality of life in patients with relapsing–remitting multiple sclerosis.

## Contribution

The study shows that fear of relapse and health anxiety independently impact quality of life in RRMS patients beyond clinical factors.

## Key findings

- Fear of relapse and health anxiety are strongly linked to lower physical and mental quality of life in RRMS patients.
- Health anxiety showed stronger correlations with quality of life than fear of relapse.
- Demographic and clinical variables had no significant association with quality of life.

## Abstract

Relapsing–remitting multiple sclerosis (RRMS) is characterized by unpredictable relapses that affect neurological and psychological functioning. Among psychosocial factors, fear of relapse (FoR) has been increasingly studied in relation to quality of life (QoL). This study examined the associations of FoR and health anxiety with QoL in RRMS.

In this cross-sectional study, 94 RRMS patients and 50 demographically comparable healthy controls were included. Participants completed the Expanded Disability Status Scale (EDSS), FoR Scale, Health Anxiety Inventory (HAI-18), and Short Form-36 (SF-36). Between-group comparisons were conducted for descriptive purposes. Correlation and hierarchical regression analyses were restricted to the RRMS group.

Compared with healthy controls, RRMS patients had higher health anxiety and lower physical and mental QoL scores (all p < 0.001). Within the RRMS group, FoR was negatively correlated with physical (r = −0.537) and mental QoL (r = −0.481), while health anxiety showed stronger negative correlations (all p < 0.001). In hierarchical regression analyses, demographic and clinical variables were not significantly associated with QoL. The inclusion of health anxiety and FoR increased explained variance to 50.4% for physical QoL and 46.8% for mental QoL. Both variables were significantly and negatively associated with QoL in final models.

FoR and health anxiety are significantly associated with QoL in RRMS. While health anxiety demonstrated comparatively stronger associations, FoR was also related to QoL beyond demographic and clinical variables, supporting the clinical relevance of both general and disease-specific anxiety processes.