Cognitive and Emotional Predictors of Health-Related Quality of Life in Pediatric-Onset Multiple Sclerosis

Background: Pediatric-onset multiple sclerosis (POMS) affects children's health-related quality of life (HRQOL). This study aimed to examine the role of parents' and children's perspectives on HRQOL. Since identification of predictors for HRQOL is crucial to intervention and patients' QOL, this study focused on identifying cognitive and emotional predictors of POMS patients' HRQOL. Methods: A cross-sectional study assessing HRQOL predictors from child and parent reports in 30 children with POMS (mean age = 15.76 years, 63% female). Children were assessed for HRQOL, psychological, and cognitive functioning. HRQOL was measured using self- and parent-reports on the Pediatric Quality of Life Inventory, evaluating physical health, psychological, social, and school functioning. Predictors included cognitive functioning (processing speed, attention, memory), psychological functioning (depression, anxiety), and disease severity (Expanded Disability Status Scale). Multiple regressions identified predictors of child- and parent-reported HRQOL, and correlations examined relationships between significant predictors and HRQOL subdomains. Results: School functioning was the most affected HRQOL domain, followed by physical health, emotional, and social functioning. Self-reported HRQOL was predicted solely by psychological functioning: anxiety and depression significantly predicted child-reported HRQOL, with anxiety having the strongest impact. Parent-reported HRQOL was predicted by processing speed, attention, and depression, with cognitive functioning relating to school, physical, and social domains, while depression was linked to psychological HRQOL. Conclusions: Children's HRQOL perceptions were strongly shaped by anxiety and depressive symptoms, whereas parents emphasized mainly cognitive functioning. Integrating both perspectives in clinical assessments is essential. Addressing anxiety and depression in children, alongside cognitive rehabilitation and parental education, may enhance HRQOL in POMS.