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

Abstract

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 > or =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 < or = 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.

Anxiety and social activities in multiple sclerosis patients

“…The present study shows that persons with MS report symptoms of anxiety (20.2%) in a statistically significantly higher proportion than that in the normal population; these results are in line with other publications, for instance: Beiske, 19.3% [15]; Korostil, 18.6% [16]; Kehler, 25.0% [17]; and Dahl, 30.2% [18]. However, the prevalence of anxiety and its relation to socio-demographic and clinical characteristics of the MS patient population is much less thoroughly investigated than prevalence of depression in the general population and needs much more attention from scientists [19].…”

Correlations between depression, cognitive status, functional scores, disability and lesion load in multiple sclerosis treated with interferon beta 1a

“…A study of 50 MS patients attending an outpatient clinic reported that BDI scores increased with disease severity and physical disability but not with disease duration (15,(27)(28)(29)(30)(31) In this study we found a significant correlation between depression and an objective measure of disability, the EDSS. Separate calculations of the correlation between depression and the 8 functional systems of the EDSS revealed that only bowel and bladder dysfunction and sensitive score were correlated with BDI score.…”

“…Twenty-three patients showed no symptoms of depression (BDI score 1-10), 4 patients had mild mood disturbance (BDI score 11-16), 3 had borderline clinical depression (BDI score [17][18][19][20], and 2 had moderate depression (BDI score [21][22][23][24][25][26][27][28][29][30]. The mean BDI score was 8.71±7.…”

Depression and anxiety in a Portuguese MS population: Associations with physical disability and severity of disease

“…These limitations may result in an overestimation of anxiety and depression [15]. Unlike most screening instruments, the Hospital Anxiety and Depression Scale (HADS) [16] was designed to prevent false-positives in somatic conditions; has been validated for medically ill patients and is widely used in MS [15][16][17][18]. The ideal HADS subscales' cut-off points for MS are a matter of debate.…”