The mediating role of alexithymia and facial emotion recognition in the impact of anxiety and depression on quality of life in adolescents diagnosed with Multiple Sclerosis

Aim: Multiple sclerosis (MS) is rare in the pediatric population, and the literature on its impact on this population is limited. This study aims to compare adolescents with MS and their non-MS peers in terms of quality of life, anxiety, depression, alexithymia, and facial emotion recognition, and to examine the direct and indirect effects of these variables on quality of life among adolescents with MS. Material and Method: A total of 87 participants aged 14 to 18 were evaluated, including 43 in the MS group and 44 in the comparison group. Participants were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL-DSM-5) and the Faces Test, and completed the Pediatric Quality of Life Inventory (PedsQL), the Revised Child Anxiety and Depression Scale (RCADS), and the Toronto Alexithymia Scale–20 (TAS-20). Results: The MS group showed a significantly higher rate of psychiatric diagnoses (58.14%) than the comparison group (18.18%). No significant group differences were found in quality of life, anxiety, depression, alexithymia, or facial emotion recognition. In the MS group, anxiety, depression, and alexithymia were negatively correlated with quality of life. Age and depression were found to predict quality of life. Alexithymia and facial emotion recognition did not mediate the impact of anxiety and depression on quality of life. Conclusion: The rate of psychiatric diagnoses is high among adolescents with MS. The findings highlight the importance of assessing depressive symptoms. Further research with larger samples is needed to clarify the mediating roles of alexithymia and emotion recognition.