Anxiety and depression in multiple sclerosis. A comparative population-based study in Nord-Trøndelag County, Norway

2009 ◽  
Vol 15 (12) ◽  
pp. 1495-1501 ◽  
Author(s):  
Ole-Petter Dahl ◽  
Eystein Stordal ◽  
Stian Lydersen ◽  
Rune Midgard
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Depression Scale ◽  
Population Based ◽  
Anxiety And Depression ◽  
Multiple Sclerosis Population ◽  
Neuropsychiatric Manifestations ◽  
Duration Of Disease ◽  
Fatigue Severity ◽  
Multiple Sclerosis Patients

Anxiety and depression are widely distributed symptoms among multiple sclerosis patients and in the general population. We assessed the prevalence of anxiety and depression in the multiple sclerosis population in Nord-Trøndelag County, Norway compared with Norway’s general population. The Hospital Anxiety and Depression Scale questionnaire was completed by 172 MS patients and 56,000 controls. A cut-off of ≥8 was used to define significant symptoms of anxiety and depression. Fatigue was measured using Krupp’s Fatigue Severity Scale, with a mean cut-off of >4. Among men, 31.1% of the multiple sclerosis patients reported anxiety, while only 12.1% of the control population reported this symptom ( p = 0.002). For women, the prevalence of anxiety was 29.7% versus 17.4% ( p < 0.001). Depression was reported by 26.2% of the men with multiple sclerosis compared with 10.8% of the controls ( p < 0.001). The corresponding figures for women were 25.2% versus 10.4% ( p < 0.001). Anxiety and depression were not correlated with duration of disease or disability measured by the Expanded Disability Status Scale. Among women, fatigue was associated with anxiety ( p ≤ 0.010) and depression ( p = 0.007). No such association was found among men. Anxiety and depression occur more frequently in multiple sclerosis patients than in the general population. Fatigue was associated with these neuropsychiatric manifestations in only women.

An excessive risk of suicide may no longer be a reality for multiple sclerosis patients

2017 ◽  
Vol 23 (6) ◽  
pp. 864-871 ◽  
Author(s):  
Shoshannah Kalson-Ray ◽  
Gilles Edan ◽  
Emmanuelle Leray ◽  
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Population Based ◽  
Sensitivity Analyses ◽  
Clinical Onset ◽  
Increased Risk ◽  
Multiple Sclerosis Patients ◽  
Mean Time ◽  
Long Term Mortality

Background: Few recent studies have shown that there is no longer an increased risk of suicide in patients affected with multiple sclerosis (MS). Objectives: To describe suicide cases within a large French MS cohort and assess whether MS patients are at a higher risk of suicide compared with the general population. Methods: Data derives from a study on long-term mortality of 27,603 prevalent cases from 15 MS specialist centres. Of 1,569 deceased MS patients (5.7%) on 1 January 2010, 47 were suicides. Results: The mean time between MS clinical onset and death was 13.5 years (standard deviation (SD): 9.3 years; none within the first 3 years) and was significantly shorter than for MS patients who had died from other causes (mean = 21.4 (SD = 11.6), p < 0.0001). Age at death was also lower (46.3 vs 56.7). The standardized mortality rates were around 1 in several sensitivity analyses, reflecting no excess mortality in MS compared with general population. Conclusion: Our findings indicate that an excess suicide risk may no longer be true for MS patients and highlight the changing profile of cases, occurring later in the disease course. Further studies in population-based registries are needed to confirm and explain these potential changes (e.g. treatments’ impact?).

Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients

2009 ◽  
Vol 15 (12) ◽  
pp. 1518-1524 ◽  
Author(s):  
Kimia Honarmand ◽  
Anthony Feinstein
Keyword(s):  
Multiple Sclerosis ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Depression Scale ◽  
Area Under The Curve ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Dsm Iv ◽  
Roc Area ◽  
Multiple Sclerosis Patients

Detecting clinically significant symptoms of depression and anxiety in medically ill patients using self-report rating scales presents a challenge because of somatic confounders. The Hospital Anxiety and Depression Scale (HADS) was developed with this in mind, but has never been validated for a multiple sclerosis population. Our objective was to validate the HADS for multiple sclerosis patients. Multiple sclerosis patients were interviewed for the presence of major depression ( n = 180) and anxiety disorders ( n = 140) with the Structured Clinical Interview for DSM-IV disorders. A receiver operating characteristic (ROC) analysis was undertaken to assess which HADS cut-off scores give the best yield with respect to diagnoses of major depression and all anxiety disorders defined by the Structured Clinical Interview for DSM-IV. A threshold score of 8 or greater on the HADS depression subscale provides a sensitivity of 90% and specificity of 87.3% (ROC area under the curve 0.938). The same cut-off score gives a sensitivity of 88.5% and a specificity of 80.7% on the anxiety subscale (ROC area under the curve 0.913), but for generalized anxiety disorder only. The study confirms the usefulness of the HADS as a marker of major depression and generalized anxiety disorder, but not other anxiety disorders, in multiple sclerosis patients.

Multiple sclerosis: psychological and psychopathological study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1196-1196
Author(s):  
R. Curral ◽  
C. Silveira ◽  
A. Norton ◽  
I. Domingues ◽  
S. Silva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Short Form ◽  
Depression Scale ◽  
Medical Outcomes ◽  
Duration Of Illness ◽  
Neuropsychiatric Manifestations ◽  
The Central Nervous System ◽  
Duration Of Disease ◽  
General Physical

Multiple Sclerosis (MS) is the most common demyelinating disease of the central nervous system and one that presents more neuropsychiatric manifestations.The authors of this paper proposes to characterize psychological and psychopathologically a group of patients sent from Neurology to Psychiatry at St. João Hospital - Porto.The initial group consisted of 48 patients (35 women and 13 men). Data collection was done through a semi-formant interview to obtain socio-demographic and clinical data. The psychological and psychopathological evaluation was made with the following tools: MMSE (Mini Mental State Examination), Raven, MOS SF-36 (Medical Outcomes Study 36-Item Short Form Health Survey), SCL-90 (Hopkins Symptoms Distress Checklist 90), HADS (Hospital Anxiety and Depression Scale), scale and EDSS (Expanded Disability Status Scale).On this sample the median duration of disease was 11 years and the value of EDSS has an average of 2.49. The sample does not show significant levels of psychopathology. However the results suggest that the worse is the overall severity of MS (EDSS) and the greater the duration of illness, the worst seems to be general physical and emotional functioning. In this study, no associations were found between variables of MS and psychopathological findings. However cognitive dysfunction appears to worsen with the greatest severity of MS, as in other works.

In multiple sclerosis anxiety, not depression, is related to gender

2015 ◽  
Vol 22 (2) ◽  
pp. 239-244 ◽  
Author(s):  
Marie Théaudin ◽  
Kristoffer Romero ◽  
Anthony Feinstein
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Linear Regression Analysis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
High Prevalence ◽  
Psychiatric Sequelae ◽  
The Impact

Background: There is a high prevalence of depressive and anxiety disorders in multiple sclerosis (MS), a disease 2.5 times more frequent in females. Contrary to the general population, in whom studies have demonstrated higher rates of depression and anxiety in females, little is known about the impact of gender on psychiatric sequelae in MS patients. Objectives: We conducted a retrospective study to try to clarify this uncertainty. Methods: Demographic, illness-related and behavioral variables were obtained from a neuropsychiatric database of 896 patients with a confirmed diagnosis of MS. Symptoms of depression and anxiety were obtained with the Hospital Anxiety and Depression Scale (HADS). Gender comparisons were undertaken and predictors of depression and anxiety sought with a linear regression analysis. Results: HADS data were available for 711 of 896 (79.35%) patients. Notable gender differences included a higher frequency of primary progressive MS in males ( p = 0.002), higher HADS anxiety scores in females ( p < 0.001), but no differences in HADS depression scores. Conclusion: In MS, gender influences the frequency of anxiety only. This suggests that the etiological factors underpinning anxiety and depression in MS are not only different from one another, but also in the case of depression, different from those observed in general population samples.

scholarly journals Psychometric Properties of the HADS Measure of Anxiety and Depression Among Multiple Sclerosis Patients in Croatia

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Jerković ◽  
Ana Proroković ◽  
Meri Matijaca ◽  
Jelena Vuko ◽  
Ana Poljičanin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychometric Properties ◽  
Factor Structure ◽  
Convergent Validity ◽  
Online Survey ◽  
Depression Scale ◽  
Psychological Status ◽  
Anxiety And Depression ◽  
Study Objective ◽  
Multiple Sclerosis Patients

Depression and anxiety are common complaints in patients with multiple sclerosis (MS). The study objective was to investigate the factor structure, internal consistency, and correlates of the Croatian version of the Hospital Anxiety and Depression Scale (HADS) in patients with MS. A total of 179 patients with MS and 999 controls were included in the online survey. All subjects completed the HADS and self-administered questionnaires capturing information of demographic, education level, disease-related variables, and the Multiple Sclerosis Impact Scale-29 (MSIS-29). Psychometric properties were examined by estimating the validity, reliability, and factor structure of the HADS in patients with MS. The two HADS subscales (anxiety and depression) had excellent internal consistencies (Cronbach’s α value 0.82–0.83), and factor analysis confirmed a two-factor structure. The convergent validity of the HADS subscales appeared to be good due to the significant correlations between HADS and MSIS-29. Receiver operating characteristic (ROC) analysis indicates that the HADS subscales have a significant diagnostic validity for group differentiation. Hierarchical regression analysis using MSIS-29 subscales as criterion variables showed consistent evidence for the incremental validity of the HADS. The HADS is a reliable and valid self-assessment scale in patients with MS and is suggested to be used in clinical monitoring of the psychiatric and psychological status of patients with MS.

scholarly journals Depression, anxiety and blood serotonin in patients with multiple sclerosis during Betaferon treatment

2008 ◽  
Vol 7 (5-2) ◽  
pp. 424-427
Author(s):  
T. N. Trushnikova ◽  
T. V. Bajdina
Keyword(s):  
Multiple Sclerosis ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Immunomodulating Therapy ◽  
Blood Serotonin ◽  
Immunoenzyme Analysis ◽  
Multiple Sclerosis Patients

Depression and anxiety were examined by Hospital Anxiety and Depression Scale and Spilberger Scale in 217 multiple sclerosis patients treated by Betaferon. The concentration of blood serotonin was determined by immunoenzyme analysis in 71 of them. The multiple sclerosis patients had progressive high levels of depression ((7,55 ± 3,61) points; р = 0,000) and anxiety ((7,55 ± 3,61) points; р = 0,000), and the decreased blood serotonin concentration ((210 ± 134,2) versus (269 ± 98,8) ng/ml; р = 0,036 in healthy people). The level of anxiety was related to the level of serotonin depression. Betaferon did not correct the affective disorders in multiple sclerosis patients, except the decreasing the degree of anxiety, and did not normalize the level of blood serotonin, that suggest the use of selective serotonin reuptake inhibitors during immunomodulating therapy.

scholarly journals Effects of between-person differences and within-person changes in symptoms of anxiety and depression on older age cognitive performance

2017 ◽  
Vol 48 (8) ◽  
pp. 1350-1358 ◽  
Author(s):  
E. J. Laukka ◽  
D. Dykiert ◽  
M. Allerhand ◽  
J. M. Starr ◽  
I. J. Deary
Keyword(s):  
Cognitive Function ◽  
Cognitive Performance ◽  
Negative Mood ◽  
Depression Scale ◽  
Population Based ◽  
Older Age ◽  
Anxiety And Depression ◽  
Sample Mean ◽  
Assessment And Treatment ◽  
Lothian Birth Cohort

AbstractBackgroundAnxiety and depression are both important correlates of cognitive function. However, longitudinal studies investigating how they covary with cognition within the same individual are scarce. We aimed to simultaneously estimate associations of between-person differences and within-person variability in anxiety and depression with cognitive performance in a sample of non-demented older people.MethodsParticipants in the Lothian Birth Cohort 1921 study, a population-based narrow-age sample (mean age at wave 1 = 79 years, n = 535), were examined on five occasions across 13 years. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS) and cognitive performance was assessed with tests of reasoning, logical memory, and letter fluency. Data were analyzed using two-level linear mixed-effects models with within-person centering.ResultsDivergent patterns were observed for anxiety and depression. For anxiety, between-person differences were more influential; people who scored higher on HADS anxiety relative to other same-aged individuals demonstrated poorer cognitive performance on average. For depression, on the other hand, time-varying within-person differences were more important; scoring higher than usual on HADS depression was associated with poorer cognitive performance relative to the average level for that participant. Adjusting for gender, childhood mental ability, emotional stability, and disease burden attenuated these associations.ConclusionsThe results from this study highlight the importance of addressing both between- and within-person effects of negative mood and suggest that anxiety and depression affect cognitive function in different ways. The current findings have implications for assessment and treatment of older age cognitive deficits.

Olfactory dysfunction in multiple sclerosis: association with secondary progression

2011 ◽  
Vol 18 (5) ◽  
pp. 616-621 ◽  
Author(s):  
Ana Martins Silva ◽  
Ernestina Santos ◽  
Inês Moreira ◽  
Andreia Bettencourt ◽  
Ester Coutinho ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Clinical Markers ◽  
Systematic Assessment ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Threshold Score ◽  
State Examination ◽  
Smell Identification

Objective: The Brief Smell Identification Test (B-SIT) was used to explore odour identification capacities in multiple sclerosis (MS). Methods: In total, 153 consecutive patients with MS and 165 healthy controls (HC) participated in the study. All participants were asked to answer the B-SIT and the Hospital Anxiety and Depression Scale (HADS). The Expanded Disability Status Scale (EDSS), the Multiple Sclerosis Severity Scale (MSSS), and the Mini-Mental State Examination (MMSE) were used for patients’ clinical and cognitive characterization. Results: Patients with MS (11.1%) were more impaired on the B-SIT than HC participants (3%). The frequency of impairment was higher for patients with secondary progressive (SPMS; 11/16, 68.8%) than relapsing–remitting (RRMS; 4/121, 3.3%) or primary progressive (2/16, 12.5%) courses. A threshold score of ≤ 8 on the B-SIT provided a sensitivity of 69% and a specificity of 97% in the identification of SPMS among patients with relapsing onset. The association between SPMS and impaired B-SIT remained statistically significant after adjusting for demographic (i.e. age and education), clinical (i.e. disease duration, EDSS, and MSSS), psychopathological (i.e. HADS anxiety and depression scores), and cognitive (i.e. MMSE) variables. Conclusions: A brief odour identification measure provided a good discrimination between SPMS and RRMS courses. A systematic assessment of olfactory functions may contribute to the development of clinical markers of SPMS.

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