Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy

Abstract

Associations between psychopathology and gender, duration of MS, disability and therapy with beta-interferons were studied in multiple sclerosis (MS) outpatients. A controlled descriptive epidemiological study was carried out in two Italian outpatient MS centres on 50 outpatients with clinically definite relapsing-remitting MS presenting for regular follow-up and 50 healthy controls matched for sex, age and educational level. Subjects were assessed with the Structured Clinical Interview for DSM-IV (SCID I), the Beck Depression Inventory (BDI) and the State Trait Anxiety Inventory (STAI). MS patients reported a higher prevalence of psychiatric disorders (odds ratio 3.17), with 46% (n=23) suffering from major depressive disorder. The risk of suffering from any non-mood psychiatric disorder was also higher in MS patients than in controls (odds ratio 2.67). Risk factors for depression were female sex and severity of disability, but not therapy with interferon beta or longer duration of illness. Disability level, but not therapy with beta-interferons, is a risk factor for depression in MS outpatients. Regular screening for depression in this population is appropriate.

Psychiatric Issues in Multiple Sclerosis

“…Several studies using self-report scales of anxiety symptoms have found a point prevalence of clinically significant anxiety ranging from 25-41%. [38,[60][61] Only two studies have used structured clinical interviews to evaluate formal diagnoses of anxiety disorders, and both of these found lifetime prevalence rates of 36% [10,62], which is much higher than the 25% lifetime rate of anxiety disorders in the general population reported in the National Comorbidity Survey. [63] Generalized anxiety disorder appears to be the most common anxiety disorder among persons with MS, with 18.6% of patients meeting criteria for this disorder.…”

“…[63] Generalized anxiety disorder appears to be the most common anxiety disorder among persons with MS, with 18.6% of patients meeting criteria for this disorder. [10,62] Panic disorder and obsessive compulsive disorder may also be much more common among MS patients than among the general population. MS patients with anxiety disorders were more likely to be female, and to have a lifetime diagnosis of major depressive disorder or alcohol abuse.…”

“…Major depressive disorder, 12-month 15.7% [33] 7.4% [33] Major depressive disorder, lifetime 22.8% [40] 16.2% [97] Any anxiety disorder, lifetime 36% [10,62] 25% [63] Generalized anxiety disorder 18.6% [10,62] 3.0% [98] Bipolar disorder, lifetime 0.3% [72] 0.2% [99] Alcohol abuse, lifetime 13.6% [77] 7.4% [100] Substance misuse, past month 18.7% [78] 11.1% [100] …”

Depression Levels and Interferon Treatment in People with Multiple Sclerosis

“…According to these studies, factors intrinsic to the individual are correlated with depression levels. Predictors cited include a history of psychiatric illness prior to starting interferon treatment, 2,15,16 female sex, 17,18 lower age, 18 severity of disability, 17,19 and presence of depressive symptoms at baseline (measured at the start of the investigation). 19 Interferon use was not associated with depressive symptoms.…”

Coping et qualité de vie dans la sclérose en plaques et la maladie de Parkinson : une réflexion clinique

“…Nous avons, quant à nous, utilisé un questionnaire standardisé [20] basé sur une des Cependant, les symptômes dépressifs sont un peu plus courants dans la SEP que dans la MP [13,21,39].…”