Anxiety, depression and fatigue at 5-year review following CNS demyelination.


Journal Article

BACKGROUND:Anxiety and depression are common in multiple sclerosis (MS). We evaluated the prevalence and factors associated with anxiety, depression and fatigue at the 5-year review of a longitudinal cohort study following a first clinical diagnosis of CNS demyelination (FCD). METHODS:Cases with a FCD were recruited soon after diagnosis and followed annually thereafter. A variety of environmental, behavioural and clinical covariates were measured at five-year review. Anxiety and depression were measured using the Hospital Anxiety & Depression Scale (HADS), and fatigue by the Fatigue Severity Scale (FSS). RESULTS:Of the 236 cases, 40.2% had clinical anxiety (median HADS-A: 6.0), 16.0% had clinical depression (median HADS-D: 3.0), and 41.3% had clinical fatigue (median FSS: 4.56). The co-occurrence of all three symptoms was 3.76 times greater than expectation. Younger age, higher disability, concussion or other disease diagnosis were independently associated with a higher anxiety score; male sex, higher disability, being unemployed, less physical activity, and antidepressant and/or anxiolytic-sedative medication use were independently associated with a higher depression score. Higher disability, immunomodulatory medication use, other disease diagnosis and anxiolytic-sedative medication use were independently associated with having fatigue, while female sex, higher BMI, having had a concussion, being unemployed and higher disability were associated with a higher fatigue score. CONCLUSION:These results support previous findings of the commonality of anxiety, depression and fatigue in established MS and extend this to post-FCD and early MS cases. The clustering of the three symptoms indicates that they may share common antecedents.

Full Text

Cited Authors

  • Simpson, S; Tan, H; Otahal, P; Taylor, B; Ponsonby, A-L; Lucas, RM; Blizzard, L; Valery, PC; Lechner-Scott, J; Shaw, C; Williams, D; Ausimmune/AusLong Investigators Group, ; van der Mei, I

Published Date

  • December 2016

Published In

Volume / Issue

  • 134 / 6

Start / End Page

  • 403 - 413

PubMed ID

  • 26756925

Pubmed Central ID

  • 26756925

Electronic International Standard Serial Number (EISSN)

  • 1600-0404

International Standard Serial Number (ISSN)

  • 0001-6314

Digital Object Identifier (DOI)

  • 10.1111/ane.12554


  • eng