Abstract
Background
Mood disorders, namely depression and anxiety, have been well documented in patients
with Multiple Sclerosis (MS). However, the putative associations between clinical
features and mood disorders have not been well established.
Objectives
To detect anxiety and depression in MS patients; and to investigate possible associations
with clinical factors.
Subjects and methods
325 consecutive patients with MS and 183 healthy subjects answered the Hospital Anxiety
and Depression Scale (HADS), a self-rating questionnaire. Multiple Regression Analysis
and Multivariate Analysis of Covariance were applied to assess the effect of demographic
and clinical factors on HADS' anxiety and depression scores, using age and disease
duration as covariates. Logistic Regression Analysis was used to study the influence
of these factors on anxiety and depression, as defined by two different cut-off scores
(i.e., 8 and 11).
Results
Levels of anxiety and depression were significantly higher (p<0.001) for MS patients group than healthy subjects. Age, disease duration, age at
onset, Kurtzke Expanded Disability Status Scale, and Multiple Sclerosis Severity Scale
were positively associated with depression scores. Low education (i.e., <9 years) in MS was significantly associated with more anxiety and depression symptoms.
Conclusions
The study findings support a close linkage between depressive mood and physical manifestations
of MS.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Multiple sclerosis—a global disorder and still poorly managed.Lancet Neurol. 2008; 7: 1078-1079
- Major depression in multiple sclerosis: a population-based perspective.Neurology. 2003; 61: 1524-1527
- Mood disorders and multiple sclerosis.Arch Neurol. 1987; 44: 376-378
- Depression as a major symptom of multiple sclerosis.J Neurol Neurosurg Psychiatry. 1980; 43: 861-865
- Multiple sclerosis beyond EDSS: depression and fatigue.J Neurol Sci. 2009; 277: S37-S41
- Biopsychosocial correlates of major depression in a multiple sclerosis population.Mult Scler. 2000; 6: 115-120
- Depression and multiple sclerosis.Neurology. 1996; 46: 628-632
- Factors influencing quality of life in multiple sclerosis patients: disability, depressive mood, fatigue and sleep quality.Acta Neurol Scand. 2004; 110: 6-13
- Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behaviour change.J Neurol Sci. 2005; 231: 29-34
- Treatment of depression improves adherence to interferon B-1b therapy for multiple sclerosis.Arch Neurol. 1997; 54: 531-533
- Cause of death in patients attending multiple sclerosis clinics.Neurology. 1991; 41: 1193-1196
- Suicide and multiple sclerosis: an epidemiological investigation.J Neurol Neurosurg Psychiatry. 1992; 55: 542-545
- Lectures on the diseases of nervous system. Henry C Lea, Philadelphia1879
- Depression in multiple sclerosis: a quantitative review of the evidence.Neuropsychology. 2005; 19: 152-158
- Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients.Mult Scler. 2009; 15: 1518-1524
- The Hospital Anxiety and Depression Scale.Acta Psychiatr Scand. 1983; 67: 361-370
- Depression and anxiety in multiple sclerosis. A clinical and MRI study in 95 subjects.J Neurol. 2001; 248: 416-421
- Anxiety and depression in multiple sclerosis. A comparative population-based study in Nord-Trondelag County, Norway.Mult Scler. 2009; 15: 1495-1501
- The validity of the Hospital Anxiety and Depression Scale. An updated literature review.J Psychosom Res. 2002; 52: 69-77
- Prevalence of psychiatric disorders in medical patients.J Nerv Ment Dis. 1996; 184: 43-51
- Screening instruments for depression and anxiety after stroke — experience in the Perth Community Stroke Study.Acta Psychiatr Scand. 1995; 91: 252-257
- Diagnostic criteria for multiple sclerosis: 2005 revisions to the “Mc Donald Criteria”.Ann Neurol. 2005; 58: 840-846
- Escalas e testes na demência. 2nd Ed. GEECD, Lisboa2008
- Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale.Psychol Health Med. 2007; 12: 225-235
- Neurologic impairment in multiple sclerosis and disability status scale.Acta Neurol Scand. 1970; 46: 493-512
- Multiple sclerosis severity score. Using disability and disease duration to rate disease severity.Neurology. 2005; 64: 1144-1151
- Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population.Br J Psychiatry. 2001; 179: 540-544
- Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy.Neurol Sci. 2005; 26: 255-262
- Anxiety disorders and their clinical correlates in multiple sclerosis patients.Mult Scler. 2007; 13: 67-72
- Predictors of depression in multiple sclerosis patients.Acta Neurol Scand. 2010; 121: 161-170
- Depression as a function of length and severity of illness, age, remission and perceived social support.J Clin Psychol. 1984; 40: 1028-1033
- Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis.Neurology. 2006; 66: 685-692
- Depression and multiple sclerosis: a review.J Neurol Neurosurg Psychiatry. 2005; 76: 469-475
- Psychological aspects of multiple sclerosis.Clin Neurol Neurosurg. 2008; 110: 868-877
- Lesion pattern in patients with multiple sclerosis and depression.Mult Scler. 2000; 6: 156-162
- Brain lesion volume and neuropsychological function predict efficacy of treatment for depression in multiple sclerosis.J Consult Clin Psychol. 2003; 71: 1017-1024
- Diffusion tensor imaging abnormalities in depressed multiple sclerosis patients.Mult Scler. 2010; 16: 189-196
- Structural brain abnormalities in multiple sclerosis patients in major depression.Neurology. 2004; 62: 586-590
- Influences of lobar gray matter and white matter lesion load on cognition and mood.Psychiatry Res. 2010; 181: 90-96
- Brain–immune communication psychoneuroimmunology.Mult Scler. 2008; 14: 6-21
- Cytokines sing the blues. Inflammation and pathogenesis of depression.Trends Immunol. 2006; 27: 24-31
- ApoE alleles, depression and positive affect in multiple sclerosis.Mult Scler. 2009; 15: 311-315
- Psychiatric side effects of interferon-B in multiple sclerosis.Eur Psychiatry. 2006; 21: 186-193
- Depressive symptoms in a treated multiple sclerosis cohort.Mult Scler. 2003; 9: 616-620
- Multiple sclerosis and depression: influence of interferon beta therapy.Mult Scler. 2003; 9: 284-288
- The prevalence and distribution of major depression in a national community sample: the national comorbidity survey.Am J Psychiatry. 1994; 151: 979-986
- A 4-year follow-up study of syndromal and sub-syndromal anxiety and depression symptoms in the general population.Soc Psychiatry Psychiatr Epidemiol. 2008; 43: 192-199
Article info
Publication history
Published online: April 18, 2011
Accepted:
March 28,
2011
Received in revised form:
March 24,
2011
Received:
February 4,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
