Restless legs syndrome symptomatology, attitudes and beliefs among treated and untreated individuals

Background: Restless legs syndrome (RLS) is an under-diagnosed and under-treated disorder in the community. Little is known regarding the factors associated with treatment seeking for RLS. Based on Andersen's behavioral model for health service utilization, we compared predisposing factors, enabling or impeding factors and need for care factors among participants without RLS (NRs), participants with untreated RLS (URs) and participants with treated RLS (TRs). Methods: The study sample consisted of 105 participants (NRs: n=41; URs: n=29; TRs: n=35) who were evaluated face-to-face based on the Hopkins Telephone Diagnostic Interview. We compared the groups with respect to sociodemographic variables, insurance status, attitudes and beliefs toward RLS and RLS treatment, symptom severity, impact on quality of life and subjective description of RLS symptoms. Results: URs were older (72.6. years versus 61.1. years) and had a higher proportion of African Americans (44.8% versus 8.6%) (p<0.01 for both). Compared to NRs and URs, TRs endorsed a stronger belief that RLS is a serious medical condition and causes marked psychosocial impairment (p<0.01 for both). TRs reported greater RLS symptom severity than URs (p<0.01), but the impact of RLS on quality on life was similar in both groups. TRs were more likely to use specific descriptors to describe symptoms of RLS than URs. Conclusions: Based on Andersen's model, predisposing and need for care factors including Caucasian race, greater concern about the impact of RLS on daily activity and more frequent endorsement of RLS symptom descriptors were associated with receiving treatment for RLS. Further study is needed to identify barriers to treatment in individuals with undiagnosed and untreated RLS in the community.