Features of depression development in myasthenia gravis.

Abstract

Features of depression development in myasthenia gravis. Kalbus O.I., Makarov S.O., Shastun N.P., Somilo O.V., Bukreyeva Yu.V. The relative risk of developing depression in myasthenia gravis is 2.14 times higher than in the general population. The features of depression in myasthenia patients remain poorly understood and need to be clarified. The purpose of this work was to study the features of the development of depression in patients with myasthenia gravis. From 2014 to 2017, 182 patients with myasthenia gravis were examined. 147 (80.8%) patients had a generalized form of the disease, 35 (19.2%) had an ocular form. The clinical examination included assessment of complaints, medical history, neurological examination, as well as MGFA (Myasthenia Gravis Foundation of America) disease class and subclass of the disease determination. The severity of myasthenia gravis has been quantified according to the QMG score (Quantitative Myasthenia Gravis Score). All the patients were examined for the titer of antibodies to acetylcholine receptors (AchR) and muscle-specific tyrosine kinase (MuSK) by enzyme-linked immunosorbent assay (ELISA). Patients were also tested for the presence of antibodies to titin and SOX1 by indirect immunofluorescence. To detect depression the Beck depression inventory (BDI) was used. The mean depression score in the total sample was 16.0 (10.0; 24.0), which corresponds to a moderate depression level. The mean depression score in patients with ocular form was 6.0 (3.0; 11.0) points (ie, depression is absent), whereas in patients with generalized myasthenia gravis-19.0 (12.0; 29.0) points (corresponds to moderate depression) (p <0.001). The distribution of patients with mild depression was also uneven: significantly bigger part of the patients was recorded with myasthenia gravis of class I (ocular form)-10 (28.6%), and with myasthenia gravis of class II-23 (44.2%). Among the patients with myasthenia gravis of class III, only 13 (20.3%) patients were reported with mild depression and 1 (3.2%) with class IV, p<0.001. The distribution of patients with moderate depression was the opposite of others: most patients had myasthenia gravis of class II-12 (18.8%), and there were no patients with myasthenia gravis of class I. A similar tendency is also observed in the case of severe depression: patients with myasthenia gravis of class II-23 (35.6%) dominated, to a lesser extent-patients with myasthenia gravis of class IV-6 (19.4%). Among patients with ocular myasthenia gravis, only 1 (2.9%) patient was found to have severe depression. Severe depression was mainly recorded in patients with myasthenia gravis of class IV-22 (71%) patients. The number of patients with severe depression has been decreased in the class of myasthenia gravis: 13 patients (20.3%) patients with ІІІ class, 1 (1.9%) with II class, no patients with class I. The degree of depression correlates with the clinical form of myasthenia gravis (ρ=-0.52; p<0.001), class (ρ=-0.30; p<0.001) and the subclass of the disease according to MGFA (ρ=-0.36; ...

Depression: A Contributing Factor to the Clinical Course in Myasthenia Gravis Patients

“…In the study of O.I. Kalbus et al [49] the hypothesis regarding the effect of disease duration on the development of depression was not confirmed, and there were no statistically significant correlations between the Beck score and disease duration.…”

Prevalence of depression and anxiety among myasthenia gravis (MG) patients: A systematic review and meta‐analysis

“…According to studies about the prevalence of anxiety and depression in MG, the epidemiology of depression in MG varies from 6% to 76% (Kalbus et al., 2020 ; Sivadasan et al., 2019 ) and anxiety varies from 3% to 71% (Sivadasan et al., 2019 ; Ybarra et al., 2011 ). So, evidence showed that MG individuals are inclined to show high rate of depression and anxiety, and studies confirmed that anxiety and depression affect the mental health of MG people.…”