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


Simpson, S and Tan, H and Otahal, P and Taylor, B and Ponsonby, AL and Lucas, RM and Blizzard, L and Valery, PC and Lechner-Scott, J and Shaw, C and Williams, D and van der Mei, I, Ausimmune/AusLong Investigators Group, Anxiety, depression and fatigue at 5-year review following CNS demyelination, Acta Neurologica Scandinavica, 134, (6) pp. 403-413. ISSN 0001-6314 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 John Wiley & Sons

DOI: doi:10.1111/ane.12554


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.

Item Details

Item Type:Refereed Article
Keywords:anxiety, depression, fatigue, first demyelinating event, multiple sclerosis, prevalence
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Simpson, S (Dr Steve Simpson JR)
UTAS Author:Tan, H (Dr Haiping Tan)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Taylor, B (Professor Bruce Taylor)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:van der Mei, I (Professor Ingrid van der Mei)
ID Code:108526
Year Published:2016
Web of Science® Times Cited:36
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-04-21
Last Modified:2022-08-30

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