Personality traits and disease worsening in multiple sclerosis: Associations with neuroticism and conscientiousness

Background: The personality traits Neuroticism and/or Conscientiousness are associated with depression, brain atrophy, cognitive impairment and job loss in multiple sclerosis (MS). Objectives: We aimed to assess whether Neuroticism and Conscientiousness predict per-year risk for MS disease worsening defined by transition to secondary progressive MS (SPMS) or disability progression on the Expanded Disability Status Scale (EDSS). Methods: In a retrospective, longitudinal analysis of 375 persons with relapsing remitting MS (PwRRMS), we evaluated Neuroticism and Conscientiousness using the NEO Five Factor Inventory. In the first analysis, PwRRMS were grouped on whether their disease course changed to SPMS. In the second analysis subjects were grouped into those with EDSS increases vs stable. Cox regression modeling was employed to account for varying length of follow-up. Results: High Conscientiousness was significantly associated with a decreased hazard of course change (HR = 0.97 per T score point of Conscientiousness, 95 % CI [0.95 to 1.00], p = .049). A trend for Conscientiousness predicting EDSS increases (HR = 0.98 per T score point of Conscientiousness, 95 % CI [0.97 to 1.00], p = .051) was observed. Neuroticism was non-significant across survival analyses. Conclusion: Conscientiousness can serve as a protective factor against MS disease worsening.