Normative data for the Hospital Anxiety and Depression Scales (HADS) in multiple sclerosis

2012 ◽  
Vol 3 (4) ◽  
pp. 172-178 ◽  
Author(s):  
Lizzy Atkins ◽  
Gavin Newby ◽  
John Pimm
2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A20-A20
Author(s):  
J Lachowicz ◽  
K Kee ◽  
P Wallbridge ◽  
J Stonehouse ◽  
A Perkins

Abstract Background Previous datasets demonstrate inconsistent relationships between apnoea-hypopnoea index (AHI) and questionnaire measures of daytime sleepiness, anxiety and depression. Methods 1149 consecutive diagnostic polysomnograms at a quaternary hospital were retrospectively analysed (2020–2021). Relationships between age, sex, AHI, Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scales (HADS-A and HADS-D) were reviewed. Progress to date:Mean age was 47.8+/-15.7 years, with male gender bias (59%). 49.9% had elevated HADS-A (>7; mean 8.1+/-4.5). 33.7% had elevated HADS-D (>7; mean 6.2+/-4.0). 29.6% had sleepiness (ESS >10; mean 7.9+/-5.0). Mean AHI was 23.5+/-27.9 events/hour. 69.7% had obstructive sleep apnoea (OSA); 45.0% were moderate-severe (AHI >14/h). HADS-A (9.1 versus 7.3; P<0.001; 95% CI [-2.32, -1.25]), HADS-D (6.9 versus 5.8; P<0.001; 95% CI [-1.62, -0.67]) and ESS (8.2 versus 7.7; P=0.039; 95% CI [-1.21, -0.03]) were higher in females. Males had greater OSA severity (AHI 27.0/h versus 18.6/h; p<0.001; 95% CI [5.15, 11.67]). Pearson’s tests demonstrated a statistically significant but weak positive correlation between AHI and HADS-A (P=0.021, R=0.07, N=1096), and AHI and ESS (P=0.042, R=0.06, N=1135). AHI and HADS-D showed no correlation. ESS weakly correlated with HADS-A (P<0.001, R=0.237, N=1104). Intended outcome and impact:Severity of sleep apnoea as defined by AHI only explains a small proportion of the variance in daytime sleepiness and anxiety as measured by the ESS and HADS-A, respectively, with weak linear relationships demonstrated. Neither ESS nor HADS-A were helpful in predicting the presence of OSA. Further study is required to determine optimal polysomnographic correlates of sleep apnoea symptoms.


2020 ◽  
pp. 135245852093407 ◽  
Author(s):  
Anthony Feinstein ◽  
Cecilia Meza ◽  
Cristiana Stefan ◽  
W Richard Staines

To assess whether symptoms of depression change when people with multiple sclerosis (pwMS) discontinue cannabis use, 40 cognitively impaired pwMS who smoked cannabis almost daily were randomly assigned to either a cannabis continuation (CC) or cannabis withdrawal (CW) group. Both groups were followed for 28 days. All participants completed the Hospital Anxiety and Depression Scale. At day 28 the 11-nor-9-carboxy-Δ9-tetrahydro-cannabinol (THCCOOH)/creatinine ratio in the CW group declined to zero ( p = 0.0001), but remained unchanged in the CC group ( p = 0.709). Depression scores in those pwMS who were using cannabis to manage their depression remained statistically unchanged in the CC group, but declined in the CW group ( p = 0.006). Despite pwMS using cannabis to help their mood, depression improved significantly off the drug. Our finding provides a cautionary note in relation to cannabis use in pwMS, at least with respect to depression.


2018 ◽  
Vol Volume 14 ◽  
pp. 3193-3197 ◽  
Author(s):  
José Luís Pais Ribeiro ◽  
Ana Martins da Silva ◽  
Estela Vilhena ◽  
Inês Moreira ◽  
Ernestina Santos ◽  
...  

2017 ◽  
Vol 41 (S1) ◽  
pp. S236-S236 ◽  
Author(s):  
H. Hoang ◽  
E. Stenager ◽  
E. Stenager

ObjectiveTo examine the risk of depression and anxiety in MS patients in the post-diagnostic period by using clinical screening instruments and a diagnostic structured clinical interview.MethodA population of 134 MS patients was examined for the risk of depression and anxiety in the post-diagnostic period of MS using the clinical screening instruments Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS). Within six weeks of diagnosis, patients with cut-off > 12 for BDI and > 7 for HADS were offered a clinical structured interview using the Schedules for Clinical Assessment in Neuropsychiatry/SCAN Version 2.1.ResultsThe prevalence of depressive symptoms and depression in the post-diagnostic period of MS was 49.2% when using the screening instruments, but only 15.2% when using the SCAN interview. For anxiety, the prevalence was 3.4% for both the screening instruments and the SCAN interview in the post-diagnostic period of MS.ConclusionMS patients have a risk of depression and anxiety in the post-diagnostic period of MS, but it is crucial to consider which tools to use in a clinical setting to investigate depression and anxiety in MS patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1698-1698 ◽  
Author(s):  
J. Aloulou ◽  
C. Hachicha ◽  
R. Masmoudi ◽  
A. Boukhris ◽  
C. Mhiri ◽  
...  

The aim of our study was to assess the prevalence of depression and anxiety in a population of patients treated for multiple sclerosis (MS) and their link with alexithymia.Method31 patients with MS according to McDonald's criteria, and followed in neurology department took part in the study. All patients were evaluated using a protocol to collect the epidemiological, clinical and evolution of the disease. We used versions of Arabized-Hospital Anxiety and Depression Scale (HADS) to assess the mood state and the Toronto Alexithymia Scale (TAS-20) for alexithymia.Results and commentsParticipants were divided on 18 women and 13 men with a mean age of 39 years. The prevalence of depression and anxiety were 42% and 52% respectively. The prevalence of alexithymia was 43%. The anxiety was correlated with the degree of disability and age of disease onset. Similarly, depression was more frequently observed in patients with higher EDSS, a long period of evolution. A positive correlation was found between alexithymia, depression and anxiety.Our study showed that half of all MS patients have mood disorders. However, depression is the most common and most disabling psychiatric disorder in MS. The place of anxiety should not be neglected because in case of comorbidity with depression, can be an aggravating factor. The frequency of alexitymia is high and appears to be positively correlated with depression and anxiety.


2013 ◽  
Vol 20 (1) ◽  
pp. 108-111 ◽  
Author(s):  
Johannis A van Rossum ◽  
Anke Vennegoor ◽  
Lisanne Balk ◽  
Bernard M Uitdehaag ◽  
Chris H Polman ◽  
...  

The use of natalizumab in multiple sclerosis has been restricted by the risk of progressive multifocal leukoencephalopathy (PML). JC virus carriership, duration of natalizumab treatment and past immunosuppression are known risk factors. This has allowed for calculated risk assessment for individual patients to be implemented. Not much data are available about the effect of JCV carriership on patient willingness to continue natalizumab. Here, we evaluated the impact of JCV seropositivity on safety feelings, anxiety and treatment continuation for patients treated with natalizumab, using a visual analog scale, the Hospital Anxiety and Depression Scale and a decisional conflict scale. Seropositivity led to an elevated anxiety level for PML ( p = 0.004). However, so far only 3% of patients have discontinued natalizumab because of JCV positivity in our cohort.


2018 ◽  
Vol 67 (4) ◽  
pp. 255-263 ◽  
Author(s):  
Maren de Moraes e Silva ◽  
Pilar Bueno Siqueira Mercer ◽  
Maria Carolina Zavagna Witt ◽  
Renata Guedes Ramina Pessoa ◽  
Camila Poletto Viveiros ◽  
...  

RESUMO Objetivo Realizar uma revisão sistemática com metanálise visando evidenciar as ferramentas de rastreio psiquiátrico mais adequadas na abordagem de pacientes adultos com esclerose múltipla avaliadas por estudos de acurácia diagnóstica. Métodos As bases de dados Medline, SciELO, PubMed e Lilacs foram utilizadas para pesquisa de artigos referentes ao tema proposto. Para essa busca, foram utilizados os termos “ multiple sclerosis psychiatric symptoms ” e “ multiple sclerosis psychiatric screening ”, sendo incluídos artigos na língua portuguesa e inglesa publicados entre 2007 e 2017. A qualidade dos estudos incluídos foi avaliada utilizando o método QUADAS. Uma metanálise foi conduzida com o auxílio do programa RevMan 5.3. Resultados Sete artigos foram selecionados para análise. A concordância dos revisores foi calculada com um kappa de 0,95. A maioria dos estudos selecionados realizou avaliação de ferramentas de rastreio para depressão, tendo apenas dois deles abordado a busca de transtornos de ansiedade. O rastreio de transtorno depressivo foi realizado a partir da avaliação de 11 instrumentos diferentes, enquanto o de ansiedade, por apenas dois. A maior parte dos testes analisados apresentou boa acurácia, e a ferramenta BAI foi a única com desempenho regular na análise da curva ROC (0,77 de área sob a curva). Os demais testes apresentaram desempenho bom ou excelente, cursando com mais de 83% na avaliação de área sob a curva. Conclusões As ferramentas HADS ( Hospital Anxiety and Depression Scale ), CESD ( Center for Epidemiological Scale – Depression ) e PHQ-9 ( Patient Health Questionnaire-9 ) parecem ser as mais indicadas para o rastreio psiquiátrico de pacientes com esclerose múltipla. Registro PROSPERO: CRD42017082741.


2014 ◽  
Vol 16 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Tessa M. Watson ◽  
Emma Ford ◽  
Esme Worthington ◽  
Nadina B. Lincoln

Background: Valid assessments are needed in order to identify anxiety and depression in people with multiple sclerosis (MS). The objective of this study was to assess the validity of questionnaire measures of mood in people with MS. Methods: People with MS were recruited from a clinic database and asked to complete and return a questionnaire containing the Beck Anxiety Inventory (BAI), Beck Depression Inventory–II (BDI-II), and Hospital Anxiety and Depression Scale (HADS). Those who returned the questionnaire were invited to complete a structured clinical interview, which was blind to the results of the questionnaire. Results: The BDI-II and HADS were both found to be valid measures to detect depression and anxiety in people with MS. An optimum cutoff score of 23 for the BDI-II yielded high sensitivity (85%) and high specificity (76%). An optimum cutoff score of 11 for the HADS demonstrated high sensitivity and specificity for both the Anxiety subscale (sensitivity 90%, specificity 92%) and the Depression subscale (sensitivity 77%, specificity 81%). The BAI had high sensitivity (80%) but poor specificity (46%) for detecting anxiety. Conclusion: The BDI-II and HADS can be used to identify mood disorders in people with MS.


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