Modifiable factors associated with depression and anxiety in multiple sclerosis

Gascoyne, Claudia; Simpson, Steve; Chen, Jing; Mei, Ingrid van der; Marck, Claudia H

doi:10.1111/ane.13132

Cited by 24 publications

(14 citation statements)

References 31 publications

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Section: Psychiatric Comorbiditiesmentioning

confidence: 99%

“…Depression and anxiety were prevalent in 27 and 40%, respectively, in the Australian Multiple Sclerosis Longitudinal Study using the Hospital Anxiety and Depression Scale (HADS), and 20% of the participants had both disorders (48). Healthier lifestyle factors were associated with a lower prevalence of depression and also milder severity of depression but not anxiety (48). Nearly 30% of the 2,544 participants had anxiety as assessed with the HADS in a cross-sectional study conducted in the MS outpatient clinic of the University of Calgary, underlining the substantial burden of anxiety for those with MS (49).…”

Section: Psychiatric Comorbiditiesmentioning

confidence: 99%

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Comorbidity in Multiple Sclerosis

2020

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Comorbidities in patients with multiple sclerosis (MS) has become an area of increasing interest in the recent years. A comorbidity is defined as any additional disease that coexists in an individual with a given index disease and that is not an obvious complication of the index disease. The aim of this review is to describe the current evidence regarding the range of comorbidities in the population with MS reported in different countries and the current knowledge about the influence of comorbidities on the clinical features and therapeutic challenges in MS. Certain comorbidities are more prevalent in people with MS such as depression, anxiety, cerebro-and cardiovascular diseases, and certain autoimmune disorders such as diabetes, thyroid disease, and inflammatory bowel disease. A previous perception of a trend toward a lower overall risk of cancer in patients with MS appears to be challenged, but there is no evidence on any higher occurrence of malignancies in the population with MS. Comorbidities may modify the clinical presentation of MS, and have implications for treatment choice, adherence, and outcome. Several comorbid conditions are associated with increased disability progression, including diabetes, hypertension, and chronic obstructive pulmonary disease. Comorbidities are common in MS from the time of diagnosis and may account for some of the heterogeneity observed in MS, including diagnostic delay, clinical presentation, degree of disability progression, rate of health care utilization, working ability, employment status, and quality of life. Coexisting diseases and polypharmacy increase the complexity of patient management and poses major challenges, particularly with the increasing number of immunosuppressive disease-modifying therapies.

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Section: Psychiatric Comorbiditiesmentioning

confidence: 99%

Section: Psychiatric Comorbiditiesmentioning

confidence: 99%

Comorbidity in Multiple Sclerosis

2020

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“…Recently, it was found that modifiable lifestyle factors, such as food, smoking, alcohol and physical activity, were associated with depression but not with anxiety. 50 This is not surprising given the importance of psychological factors. Further research into potential alleviating factors and possible treatments is therefore necessary.…”

Section: Ta B L E 2 Means and Standard Deviations Of Psychological Qumentioning

confidence: 99%

“…Our study confirms this pattern and is the first MS study on anxiety that includes demographic, disease-related and psychological variables in a multivariable analysis, including comprehensive cognitive functioning. Recently, it was found that modifiable lifestyle factors, such as food, smoking, alcohol and physical activity, were associated with depression but not with anxiety 50. The importance of coping in quality of life and in anxiety is stated in multiple MS studies 18,24,49.…”

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confidence: 99%

Anxiety in multiple sclerosis is related to depressive symptoms and cognitive complaints

et al. 2019

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Objectives: Multiple sclerosis (MS) patients suffer from high levels of anxiety.However, it is unclear which factors are related to anxiety, since study results are inconsistent, and the associated factors have not been examined comprehensively.In this study, we investigated the demographic, disease-related and psychological factors associated with anxiety in MS patients. Materials and methods:Cross-sectional data of 119 MS patients were used. Anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), fatigue (Fatigue Severity Scale), cognitive complaints (Cognitive Failures Questionnaire) and cognitive functioning (Wisconsin Card Sorting Test, Controlled Oral Word Association Test, Letter Digit Substitution Test, Concept Shifting Test, Wechsler Memory Test Faces and the Dutch version of the California Verbal Learning Test) were measured.Bivariate and multivariable regression analyses were conducted to test the associations between anxiety and potential contributing factors.Results: In this sample, 42% of the MS patients had clinically significant levels of anxiety, defined by a score ≥8 on the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS). A significant correlation was found between anxiety and depressive symptoms, fatigue, cognitive complaints and psychiatric history. In the multivariable analysis, only depressive symptoms and cognitive complaints remained significantly related to anxiety.Conclusions: Anxiety is common in MS patients and most strongly related to psychological factors. This knowledge can be taken into account when treating patients with MS. Further research is needed using longitudinal designs and incorporating other factors known to influence anxiety, such as coping, negative affectivity and social support. K E Y W O R D Sanxiety, cognition, contribute, depression, multiple sclerosis, psychological S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section.

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“…An Australian study using a representative sample of people with MS also reported much higher occurrence of these same risk factors, with 90% not meeting dietary recommendations regarding fruit and vegetable intake, 47% insufficiently physically active and 61% with a BMI outside the healthy range. 22…”

Section: Discussionmentioning

confidence: 99%

Does a modifiable risk factor score predict disability worsening in people with multiple sclerosis?

Marck¹,

Aitken

Simpson

et al. 2019

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background: Risk factors for chronic disease include smoking, hazardous alcohol consumption, physical inactivity, unhealthy body mass index and poor diet (SNAP factors). In multiple sclerosis (MS) SNAP factors are associated with health outcomes such as disability in cross-sectional studies, but longitudinal data are lacking. Objective: The objective of this study was to assess whether a combined SNAP risk score predicts disability worsening. Methods: Longitudinal self-reported data from two time-points 2.5 years apart from an international survey of 1225 people with MS were used in linear regression models adjusted for potential confounding. Disability worsening was measured using the patient-derived Multiple Sclerosis Severity Score. Results: The majority (62%) had two or more risk factors, with insufficient fruit and vegetable intake (83%), unhealthy body mass index (42%) and physical inactivity (33%) most common. Some SNAP factors at follow-up were associated with disability at follow-up (cross-sectionally), and in addition there was some evidence that increasing risk factors was associated with disability worsening over the 2.5 year study period. Baseline SNAP score was not predictive of disability worsening at follow-up, however. Conclusion: Known risk factors for morbidity and mortality were common and associated with disability cross-sectionally, but not prospectively. Further studies using longer time frames, objective measures and interventions may elucidate potential benefits from changes in risk factors on MS outcomes.

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Modifiable factors associated with depression and anxiety in multiple sclerosis

Cited by 24 publications

References 31 publications

Comorbidity in Multiple Sclerosis

Comorbidity in Multiple Sclerosis

Anxiety in multiple sclerosis is related to depressive symptoms and cognitive complaints

Does a modifiable risk factor score predict disability worsening in people with multiple sclerosis?

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