Anxiety and depressive symptoms in clinically isolated syndrome and multiple sclerosis

Abstract

Depression and anxiety have been reported in patients with multiple sclerosis (MS) and in patients with clinically isolated syndrome (CIS). However, the precise mechanisms that lead to depressive and anxiety symptoms in these patients are still unclear. In this study we evaluated with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) patients with MS and CIS and compared them to controls. We also correlated BDI and BAI scores with clinical parameters. Kruskall-Wallis followed by Dunn's Multiple Comparison Test, Chi-square and Spearman test were used. Patients with MS had higher depressive and anxiety scores than controls. The BDI and BAI scores of patients with CIS were not significantly different from controls. There was a positive correlation between BDI, BAI and EDSS. Our results corroborate the view that MS patients have higher depression and anxiety levels than control subjects. Anxiety and depressive symptoms also seem to progress according to the severity of the disease. Key words: clinically isolated syndrome, multiple sclerosis, anxiety, depression.Ansiedade e depressão em pacientes com síndrome clínica isolada e esclerose múltipla RESUMO A depressão e a ansiedade têm sido descritas em pacientes com esclerose múltipla (EM) e síndrome clinicamente isolada (CIS Conflict of interestThe authors report no conflicts of interest Multiple sclerosis (MS) is a chronic demyelinating central nervous system disease with time and space disseminated lesions. MS lesions usually have a relapsing remitting couse and affect periventricular region, optical nerves, and spinal cord 1 .

Cognitive impairment is correlated with reduced quality of life in patients with clinically isolated syndrome

“…Considering that CIS may be the first manifestation of MS and that the neuropathological abnormalities are the same only differing in intensity and distribution it seems reasonable that CIS may affect quality of life. It is possible that the impact of MS on quality of life is higher than in CIS since MS patients usually have higher neurological disability and higher rates of depression and anxiety 9 ; however, future studies are still needed to compare the reduction in quality of life in CIS and in MS patients.…”

“…Some recent studies have shown that CIS patients may present mild cognitive impairment, especially in processing speed and executive functions [4][5][6] . Depression and anxiety have also been found in patients with CIS but their precise prevalence in this population is still unknown [6][7][8][9] . Quality of life has been studied in patients with multiple sclerosis (MS) but there are no previous studies evaluating quality of life in patients with CIS.…”

“…Considering that CIS is associated with cognitive dysfunction, depression and anxiety, it is possible that it can affect quality of life in patients with CIS. However, quality of life in patients with CIS is still poorly understood 6,9,[13][14][15] . The present study aimed to evaluate the quality of life of patients with CIS and to evaluate potential determinants of quality of life such as cognition, depression and anxiety in patients with CIS.…”

Disability, depression and suicide ideation in people with multiple sclerosis

“…All except one used standardised measures, and sample sizes ranged from n = 76 -1374 except for two (n = 18 and n = 45). Since this review, several other studies have confirmed this association (Anhoque, Domingues, Carvalho, Teixeira & Domingues, 2011;Arnett et al, 2008;Beal et al, 2007;da Silva et al, 2011;Gay et al, 2010;Sarısoy et al, 2013;Smith & Arnett, 2013).…”

Emotional outcomes in clinically isolated syndrome and early phase multiple sclerosis: a systematic review and meta-analysis

“…Eleven CIS studies used five different instruments to assess depressive symptoms (Appendix 3) [44,60,69,[61][62][63][64][65][66][67][68]. The most frequently used questionnaire was BDI, which allowed for a meta-analysis of four studies (Table 2).…”