Poor Functional Outcomes Tied to Depressive Symptoms in Multiple Sclerosis

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Higher anxiety symptoms in patients with MS were associated with lower physical disability and retaining employment.
Higher anxiety symptoms in patients with MS were associated with lower physical disability and retaining employment.

Among patients with multiple sclerosis, depressive symptoms have a greater negative influence on functional outcomes when compared with anxiety symptoms, according to a study published in The Journal of Neuropsychiatry and Clinical Neuroscience.

Researchers of this retrospective study evaluated patients diagnosed with multiple sclerosis for demographic data, multiple sclerosis characteristics, and vocation status. They measured depression and anxiety with the Hospital Anxiety and Depression Scale, fatigue with the Fatigue Severity Scale, disability function on the Expanded Disability Status Scale, and cognitive function with the Symbol Digit Modalities Test.

Of the 128 patients included in this study, 95 were women, the mean age was 46.32 years, the mean disease duration was 12.21 years, and 71.9% had relapsing-remitting multiple sclerosis. Using the Hospital Anxiety and Depression Scale, 38% had depression and 57% had anxiety. Depression was associated with increased fatigue (P <.05), higher disability (P <.05), lower processing speed (P <.05), and not being currently employed (P <.05). Anxiety was associated with lower disability (P <.05) and current employment (P <.05).

Future studies need to identify a causation between depressive and anxiety symptoms and functional outcomes as well as include a more diverse subtype of multiple sclerosis diagnosis to make a more widespread conclusion.

The researchers concluded that their findings indicate depressive symptoms in patients with multiple sclerosis are more debilitating than anxiety symptoms and need to be monitored in a clinical setting.

Reference

Gill S, Santo J, Blair M, Morrow SA. Depressive symptoms are associated with more negative functional outcomes than anxiety symptoms in persons with multiple sclerosis [published online September 8, 2018]. J Neuropsychiatry Clin Neurosci. doi: 10.1176/appi.neuropsych.18010011

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