Safety, anxiety and natalizumab continuation in JC virus-seropositive MS patients

2013 ◽  
Vol 20 (1) ◽  
pp. 108-111 ◽  
Author(s):  
Johannis A van Rossum ◽  
Anke Vennegoor ◽  
Lisanne Balk ◽  
Bernard M Uitdehaag ◽  
Chris H Polman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Jc Virus ◽  
Depression Scale ◽  
Decisional Conflict ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Analog Scale ◽  
Natalizumab Treatment ◽  
Calculated Risk ◽  
The Impact

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.

Discontinuing cannabis improves depression in people with multiple sclerosis: A short report

2020 ◽  
pp. 135245852093407 ◽  
Author(s):  
Anthony Feinstein ◽  
Cecilia Meza ◽  
Cristiana Stefan ◽  
W Richard Staines
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Cannabis Use ◽  
Anxiety And Depression ◽  
Cognitively Impaired ◽  
Short Report ◽  
Hospital Anxiety ◽  
Symptoms Of Depression ◽  
Cannabis Withdrawal ◽  
Depression Change

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.

scholarly journals The hospital anxiety and depression scale, in patients with multiple sclerosis

2018 ◽  
Vol Volume 14 ◽  
pp. 3193-3197 ◽  
Author(s):  
José Luís Pais Ribeiro ◽  
Ana Martins da Silva ◽  
Estela Vilhena ◽  
Inês Moreira ◽  
Ernestina Santos ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety

The Risk of Depression and Anxiety in the Post-diagnostic Period of Multiple Sclerosis Measured by Screening Instruments and Structured Interviews

2017 ◽  
Vol 41 (S1) ◽  
pp. S236-S236 ◽  
Author(s):  
H. Hoang ◽  
E. Stenager ◽  
E. Stenager
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Structured Interview ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Screening Instruments ◽  
Hospital Anxiety ◽  
Structured Interviews ◽  
Clinical Screening ◽  
Competing Interest

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.

The relationship between fatigue and other clinical features of multiple sclerosis

2010 ◽  
Vol 17 (5) ◽  
pp. 604-612 ◽  
Author(s):  
Roger J Mills ◽  
Carolyn A Young
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Measurement Model ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Measurement Tool ◽  
Related Factors ◽  
Cross Sectional ◽  
Complex Relation ◽  
The Impact

Background: There has been considerable debate regarding the precise relationships between fatigue in multiple sclerosis (MS) and disease-related factors, such as disability, sleep disturbance, depression, age and sex. Existing studies give conflicting information. Objective: To clarify such relationships in a large cross-sectional study, using a rigorously developed measurement tool which was based on a clear definition of fatigue. Method: A pack containing the Neurological Fatigue Index for MS Summary Scale, the Hospital Anxiety and Depression Scale, the Epworth Sleepiness Scale, the Multiple Sclerosis Impact Scale and questions regarding sleep and demographics was mailed to patients with MS attending two centres in the UK. All scale scores were converted to parametric measures using the Rasch measurement model. Both linear and non-linear relationships were sought. Results: Data from 635 respondents (52% response) were analysed. Fatigue was strongly related to the impact of MS. Fatigue was worse in those with progressive disease and clearly worsened once ambulation was affected. There was only weak correlation with anxiety and depression. Fatigue was not related to disease duration or patient age. There was an intimate but complex relation between fatigue and sleep. Fatigue levels were minimum at a nocturnal sleep duration of 7.5 h. Conclusion: Clear relationships were found between fatigue and disability, disease type and sleep. Further physiological enquiry and trials of drug treatment and sleep modulation might be guided by these clinical relationships.

Depression, anxiety and multiple sclerosis: Links with alexithymia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1698-1698 ◽  
Author(s):  
J. Aloulou ◽  
C. Hachicha ◽  
R. Masmoudi ◽  
A. Boukhris ◽  
C. Mhiri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mood State ◽  
Disease Onset ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Long Period ◽  
Prevalence Of Depression ◽  
Degree Of Disability

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.

scholarly journals Testes de rastreio para alterações psiquiátricas em esclerose múltipla – Revisão sistemática com metanálise

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 ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Symptoms ◽  
Depression Scale ◽  
Patient Health Questionnaire ◽  
Anxiety And Depression ◽  
Health Questionnaire ◽  
Hospital Anxiety ◽  
Patient Health ◽  
Psychiatric Screening

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.

Course of distress, anxiety, and depression in hematological cancer patients: Association between gender and grade of neoplasm

2013 ◽  
Vol 13 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Cristiane Decat Bergerot ◽  
Karen Lynn Clark ◽  
Alexandre Nonino ◽  
Sarah Waliany ◽  
Marco Murilo Buso ◽  
...  
Keyword(s):  
Significant Interaction ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Hematological Cancer ◽  
Physical Problems ◽  
Male Patients ◽  
A Prospective Study ◽  
The Impact ◽  
Over Time

AbstractObjective:The aim of our study was to explore the impact of gender and hematological cancer grade on distress, anxiety, and depression in patients receiving chemotherapy.Methods:A prospective study was done in a cohort of 104 patients with hematological cancer. We employed the (1) Distress Thermometer (DT) and the Problem List (PL) and (2) the Hospital Anxiety and Depression Scale (HADS) for assessments at baseline (T1), the halfway timepoint (T2), and completion of chemotherapy (T3).Results:The proportion of patients experiencing significant distress (DT ≥ 4) decreased from the first to the last timepoint; the proportion experiencing anxiety and depression (as assessed by HADS) also decreased. Specifically, 50% of participants reported significant distress levels, 47.1% anxiety, and 26% depression at T1. At T2, the proportion of patients experiencing distress was reduced by 60.8%, by 76% for anxiety, and by 48.5% for depression; at T3, the reduction was close to 80% for all assessments compared with T1. Emotional and physical problems were most commonly reported. Significant reductions were discovered for distress and problem-related distress levels over time, and a significant interaction was found between gender and practical and physical problems (p < 0.05).Significance of results:Our findings suggest that female patients reported more distress, anxiety, and depression than male patients. Gender differences were related to problem-related distress but not to grade of neoplasm. We observed that, over the course of chemotherapy, the distress levels of patients with hematological cancer decrease over time.

scholarly journals Validation of Mood Measures for People with Multiple Sclerosis

2014 ◽  
Vol 16 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Tessa M. Watson ◽  
Emma Ford ◽  
Esme Worthington ◽  
Nadina B. Lincoln
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
High Sensitivity ◽  
High Specificity ◽  
Anxiety And Depression ◽  
Cutoff Score ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Depression Subscale ◽  
Anxiety Subscale

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.

scholarly journals A training program for fibromyalgia management: A 5-year pilot study

2020 ◽  
Vol 8 ◽  
pp. 205031212094307
Author(s):  
Céline Bodéré ◽  
Mathilde Cabon ◽  
Alain Woda ◽  
Marie-Agnès Giroux-Metges ◽  
Youenn Bodéré ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fibromyalgia Impact Questionnaire ◽  
Depression Scale ◽  
Moderate Intensity ◽  
Anxiety And Depression ◽  
First Year ◽  
Hospital Anxiety ◽  
Analog Scale ◽  
Continuous Training

We studied the effects of a specific cardio training program lasting 5 years on pain and quality of life in fibromyalgia patients. Method: An observational longitudinal pilot study was conducted in 138 fibromyalgia women. Fibromyalgia women recruited were asked to carry out three sessions per week, each lasting 45 min, of moderate-intensity continuous training (64%–75% Maximal Heart rate [HRmax]). During the first year, the patients progressively increased their training intensity. During the last 2 years, the patients were asked to associate moderate-intensity continuous training and high-intensity interval training (85%–90% HRmax). Pain on a visual analog scale, anxiety and depression state on the Hospital Anxiety and Depression Scale, impact of fibromyalgia on daily life using the Fibromyalgia Impact Questionnaire, heart rate and sleep quality (visual analog scale) were assessed at baseline and each year for 5 years. Results: Forty-nine patients dropped out in the first year. Depending on their training status, the remaining 89 patients were retrospectively assigned to one of the three groups: Active (moderate-intensity continuous training), Semi-Active (one or two sessions, low-intensity continuous training <60% HRmax) and Passive (non-completion of training), based on their ability to comply with the program. Alleviation of all symptoms ( p < 0.0001) was observed in the Active group. Increasing exercise intensity enhanced the effects obtained with moderate-intensity continuous training. Significant change in the Fibromyalgia Impact Questionnaire ( p < 0.0001) and depression (Hospital Anxiety and Depression Scale; p < 0.0001), and no significant decrease in pain were noted in the Semi-Active group. No effect of the training was observed in the Passive group. Conclusion: The study intervention associated with multidisciplinary care alleviated pain, anxiety and depression, and improved both quality of life and quality of sleep, in fibromyalgia patients.

scholarly journals Home-based Pilates for symptoms of anxiety, depression and fatigue among persons with multiple sclerosis: An 8-week randomized controlled trial

2021 ◽  
pp. 135245852110092
Author(s):  
Karl M Fleming ◽  
Susan B Coote ◽  
Matthew P Herring
Keyword(s):  
Multiple Sclerosis ◽  
Repeated Measures ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Analysis Of Covariance ◽  
Sensitivity Analyses ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Home Based ◽  
Anxiety Depression

Background: Symptoms of anxiety, depression and fatigue are common comorbidities among persons with multiple sclerosis (PwMS). A previous pilot study supported Pilates as a feasible exercise modality that may improve these outcomes among PwMS. Objective: To quantify the effects of 8 weeks of home-based Pilates on symptoms of anxiety, depression and fatigue among PwMS. Methods: A total of 80 PwMS (69 female) were randomized to twice-weekly home-based Pilates guided by a DVD) or wait-list control. Validated questionnaires assessed anxiety, depressive and fatigue symptoms at baseline, weeks 2, 4, 6 and 8. Using intention to treat, repeated measures analysis of covariance (RM-ANCOVA) adjusted for baseline physical activity examined between-group differences across time. Hedges’ d quantified the magnitude of differences in outcome change. Sensitivity analyses examined female-only samples. Results: Group × time interactions were statistically significant for all outcomes (all p ⩽ 0.005). Pilates significantly reduced (all p ⩽ 0.03) depressive symptoms (Quick Inventory of Depressive Symptomatology, d = 0.70; Hospital Anxiety and Depression Scale-Depression, d = 0.74), anxiety (State-Trait Anxiety Inventory, d = 0.30; Hospital Anxiety and Depression Scale-Anxiety, d = 0.49), cognitive ( d = 0.44), physical ( d = 0.78), psychosocial ( d = 0.56) and total fatigue ( d = 0.76). Female-only results were materially the same. Conclusion: Home-based Pilates significantly improved anxiety, depressive and fatigue symptoms among PwMS with minimal-to-mild mobility disability, including moderate-to-large, clinically meaningful improvements in depressive and fatigue symptoms. Trial Registration: ClinicalTrials.gov (NCT04120207)

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