Anxiety and depression in patients with multiple sclerosis

Authors

DOI:

https://doi.org/10.26641/2307-0404.2023.2.283349

Keywords:

multiple sclerosis, depression, anxiety, Beck Depression Inventory, State-Trait Anxiety Inventory, expanded disability status scale

Abstract

Multiple sclerosis is a chronic progressive inflammatory autoimmune disease of the central nervous system. This disease mainly affects young females and leads to disability of the patient, which causes a significant socio-economic burden which this disease causes. Clinically, multiple sclerosis is characterized by a wide variety of neurological and neuropsychological manifestations: movement disorders, sensory disturbances and cognitive dysfunction. One of the most typical psycho-emotional disorders that occur in patients with multiple sclerosis are anxiety and depression. The article is devoted to the study of the features of these disorders in patients with multiple sclerosis. The purpose of the study is to evaluate and characterize psycho-emotional disorders in patients with relapsing-remitting multiple sclerosis. The study included 105 patients with relapsing-remitting multiple sclerosis who underwent inpatient treatment in the Department of Neurology No. 1 Municipal Institution “Dnipropetrovsk Regional Clinic Hospital named after I.I. Mechnykov" Dnipropetrovsk Regional Council". Among the patients included in the study, there were 74 women (70.5%) and 31 men (29.5%). The largest proportion of those surveyed falls on the age group from 25 to 40 years – 80 (76.2%). All participants were assessed according to the generally accepted scale for multiple sclerosis patients assessment – Expanded Disability Status Scale (EDSS). All study participants were divided into two groups – group 1 and group 2 – according to the degree of disability according to EDSS. Considering that the degree of disability according to EDSS≤3.5 is defined as mild, and most patients had just this level, they were assigned into group 1, patients with a score of 3.5<EDSS≤6.5 points were assigned to group 2 with a moderate degree of disability. The number of participants in group 1 was 73 patients (69.5%), group 2 – 32 (30.5%). The psychoemotional sphere was assessed using validated psychodiagnostic tests: Beck Depression Inventory and the State-Trait Anxiety Inventory. The average level of depression, determined by Beck Depression Inventory, was 16.0 (13.0; 18.0) points among all examined, in patients of the 1st group – 14.0 (11.0; 16.0) points, while in patients of the 2nd group it was significantly higher (p<0.001) and amounted to 19.0 (19.0; 24.5) points. Assessment of the level of anxiety according to State-Trait Anxiety Inventory showed that in the majority of patients (84.8%) the level of reactive anxiety was moderate (31-44 points) and made up 36.0 (34.0; 39.0) points. Indicators of personal anxiety in most cases (69.5%) were low (up to 30 points) and averaged 27.0 (24.0; 31.0) points. It should be noted that the level of reactive anxiety exceeded the level of personal anxiety in the study groups and in general among all examined (p<0.001 for all comparisons). Anxiety and depression are very common psychoemotional disorders in patients with relapsing-remitting multiple sclerosis. The relationship between the degree of depression, as well as personal and reactive anxiety and the degree of disability according to the EDSS, has been revealed, but the origin of these disorders is still not clear. Given the significant influence of psycho-emotional disorders on the quality of life of patients and the course of the disease, timely diagnosis and treatment should be the priority areas of management of patients with multiple sclerosis.

References

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561-71. doi: https://doi.org/10.1001/archpsyc.1961.01710120031004

Boeschoten RE, Braamse AMJ, Beekman ATF, Cuijpers P, van Oppen P, Dekker J, et al. Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis. J Neurol Sci. 2017 Jan 15;372:331-41. doi: https://doi.org/10.1016/j.jns.2016.11.067

Dobson R, Giovannoni G. Multiple sclerosis – a review. Eur J Neurol. 2019 Jan;26(1):27-40. doi: https://doi.org/10.1111/ene.13819

Karimi S, Andayeshgar B, Khatony A. Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study. BMC Psychiatry. 2020 Apr 15;20(1):166. doi: https://doi.org/10.1186/s12888-020-02579-z

Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983 Nov;33(11):1444-52. doi: https://doi.org/10.1212/WNL.33.11.1444

Masuccio FG, Gamberini G, Calabrese M, Solaro C. Imaging and depression in multiple sclerosis: a historical perspective. Neurol Sci. 2021 Mar;42(3):835-45. doi: https://doi.org/10.1007/s10072-020-04951-z

Mustač F, Pašić H, Medić F, Bjedov B, Vujević L, Alfirević M, et al. Anxiety and Depression as Comorbidities of Multiple Sclerosis. Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):480-5. PMID: 34718269.

Ohlmeier C, Gothe H, Haas J, Osowski U, Weinhold C, Blauwitz S, et al. Epidemiology, characteristics and treatment of patients with relapsing remitting multiple sclerosis and incidence of high disease activity: Real world evidence based on German claims data. PLoS One. 2020 May 1;15(5):e0231846. doi: https://doi.org/10.1371/journal.pone.0231846

Peres DS, Rodrigues P, Viero FT, Frare JM, Kudsi SQ, Meira GM, et al. Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: A systematic review and meta-analysis. Brain Behav Immun Health. 2022 Jul 6;24:100484. doi: https://doi.org/10.1016/j.bbih.2022.100484

Petrie A, Sabin C. Medical Statistics at a Glance. 4th edition. Wiley-Blackwell; 2019. p. 208.

Solaro C, Gamberini G, Masuccio FG. Depression in Multiple Sclerosis: Epidemiology, Aetiology, Diagnosis and Treatment. CNS Drugs. 2018 Feb;32(2):117-33. doi: https://doi.org/10.1007/s40263-018-0489-5

Spielberger CD, Vagg PR, Barker LR, Donham GW, Westberry LG. The factor structure of the statetrait anxiety inventory. Stress and anxiety. 1980;7:95-109.

Tauil CB, Grippe TC, Dias RM, Dias-Carneiro RP, Carneiro NM, Aguilar ACR, et al. Suicidal ideation, anxiety, and depression in patients with multiple sclerosis. Arq Neuropsiquiatr. 2018 May;76(5):296-301. doi: https://doi.org/10.1590/0004-282x20180036

Thompson AJ, Baranzini SE, Geurts J, Hemmer B, Ciccarelli O. Multiple sclerosis. Lancet. 2018 Apr 21;391(10130):1622-36. doi: https://doi.org/10.1016/S0140-6736(18)30481-1

Wallis O, Bol Y, Köhler S, van Heugten C. An-xiety in multiple sclerosis is related to depressive symptoms and cognitive complaints. Acta Neurol Scand. 2020 Mar;141(3):212-8. doi: https://doi.org/10.1111/ane.13191

Published

2023-06-30

How to Cite

1.
Somilo O, Makarov S, Kalbus O, Sorokin A. Anxiety and depression in patients with multiple sclerosis. Med. perspekt. [Internet]. 2023Jun.30 [cited 2024Feb.23];28(2):106-11. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/283349

Issue

Section

CLINICAL MEDICINE