The impact of physical and psychological health outcomes on stigma in people with neuromyelitis optica spectrum disorder: A cross-sectional study

Abstract

Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system autoimmune disease, predominantly marked by optic neuritis and transverse myelitis. In addition to its significant physical burden, NMOSD is associated with psychological challenges, including stigma, which remains underexplored. This study aimed to investigate the stigmatization and its associations with demographic, clinical, and psychological characteristics in people with NMOSD (PwNMOSD). This cross-sectional study recruited 80 PwNMOSD in Isfahan, Iran. Data on demographic, clinical, and psychological features and quality-of-life (QoL) were obtained using medical records, neurological examinations, and standardized instruments. General linear models were employed to assess the relationships between stigma and demographic, clinical, or psychological variables. Stigma was significantly and independently associated with increased disability (Expanded Disability Status Scale, beta = 1.34, P = .002), impaired mobility (Timed 25-Foot Walk test (T25FW), beta = 1.48, P < .001), depression (beta = 0.21, P = .006), and reduced QoL (beta = 0.17, P < .001). Higher levels of stigma correlated with increased psychological distress and physical impairment. NMOSD-related stigma was strongly linked to disability, depression, and QoL, highlighting the need for targeted interventions. Addressing stigma through psychological and rehabilitative strategies may improve the well-being of PwNMOSD. Future longitudinal studies need to validate these findings.