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

Abstract

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.

Predictors of clinically significant anxiety in people with multiple sclerosis: A one-year follow-up study

“…Results did not find a relationship between cognitive functioning and clinically significant anxiety. While anxiety has been shown to negatively impact cognition in PwMS (Wallis et al, 2020;Goretti et al, 2014), specifically affecting executive functioning, memory, and information processing speed (Kalron et al, 2018), cognitive status did not result as a predictor of clinically relevant anxiety. Since our participants showed a preserved cognitive functioning, one possible speculation is that anxiety may act as a protective mechanism for PwMS preventing them to fall on cognitive tasks (Kalron et al, 2018).…”

“…One possible explanation could be that anxiety in PwMS is more associated with the perceived unpredictability of widespread symptomatology rather than with long and persistent disability and reduced ambulation as measured by EDSS. Indeed, anxiety could be most strongly related to psychological factors (e.g., depressive symptoms and fatigue) than disease-related factors (e.g., EDSS), suggesting that the way patients react to the disease (Butler et al, 2016;Wallis et al, 2020) contribute the most to anxiety.…”

“…Disease duration (Hartoonian et al, 2015), disease course (Jones et al, 2012) and EDSS (Janssens et al, 2006) were included as clinical predictors. PCO predictors were MFIS (Beiske et al, 2008;Fiest et al, 2016;Brown et al, 2009) for fatigue, MoCA (Wallis et al, 2020) for cognitive status, HADS-D for depression (Askari et al, 2014;Brown et al, 2009;Wallis et al, 2020) and HADS-A for clinically significant anxiety at baseline.…”

The Impact of Epigallocatechin Gallate and Coconut Oil Treatment on Cortisol Activity and Depression in Multiple Sclerosis Patients

“…This lipolytic effect of ketone bodies has been associated with improvements in depression [55][56][57][58]. In this line, anxiety and depressive symptomatology stand out among these types of patient [59][60][61]. This is why the study of possible associated factors with the expression of this symptomatology in MS patients becomes essential-to practically improve these patients' quality of life.…”

The Role of Cognitive Complaints in the Relationship Between Trait Anxiety, Depressive Symptoms, and Subjective Well-Being and Ill-Being in Adult Community Volunteers

“…[13][14][15] In addition, cognitive complaints are affected by various factors, including neurocognitive impairments, depression, and anxiety symptoms. [16][17][18] In the general adult population, childhood maltreatment, childhood parental bonding, and affective temperaments also influence cognitive complaints. [19][20][21] Recently, the mediating roles of cognitive complaints have been reported.…”