Wood, B and van der Mei, IAF and Ponsonby, AL and Pittas, F and Quinn, S and Dwyer, T and Lucas, RM and Taylor, BV, Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis, Multiple Sclerosis, 19, (2) pp. 217-224. ISSN 1352-4585 (2012) [Refereed Article]
Copyright 2012 The Author(s)
Background: Anxiety, depression and fatigue are commonly reported by persons with multiple sclerosis (PwMS).
Objectives: We estimated the prevalence of each factor in a representative sample of PwMS, and in subgroups defined by age, sex and disease duration, at cohort entry and over time. We further examined whether and how these factors clustered together.
Methods: A population-based longitudinal cohort of 198 PwMS was followed 6-monthly for 2.5 years. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety (cut-point > 7) and depression (> 7) and the Fatigue Severity Scale (FSS) to measure fatigue (≥ 5).
Results: At cohort entry, prevalence of anxiety was 44.5% (95%CI 37-51%), depression 18.5% (95%CI 12.6-23.4%), and fatigue 53.7% (95%CI 47-61%). Fatigue was more common in males than females (RR 1.29, p = 0.01), with attenuation of the effect after adjustment for Expanded Disability Status Scale (adjusted RR 1.18, p = 0.13). Prevalence of anxiety (but not depression or fatigue) decreased by 8.1% per year of cohort observation (RR 0.92, 95%CI 0.86-0.98, p = 0.009), with the effect more pronounced in women (14.6%, RR 0.85, 95%CI 0.79-0.93, -< 0.001) than men (2.6%, RR 1.03, 95%CI 0.90-1.17, p = 0.77). There was no apparent seasonal variation in the prevalence of any of the three factors (p > 0.05). All three factors occurred contemporaneously at cohort entry in a higher proportion of the cohort than expected by chance (p < 0.001).
Conclusions: Anxiety, depression and fatigue are common in PwMS and tend to cluster together. The findings are important for clinical management of PwMS and to the exploration of possible shared causal biological pathways.
|Item Type:||Refereed Article|
|Keywords:||multiple sclerosis, anxiety, depression, fatigue, concurrence, prevalence, Hospital Anxiety and Depression Scale, Fatigue Severity Score, prospective cohort|
|Research Division:||Medical and Health Sciences|
|Research Field:||Central Nervous System|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Nervous System and Disorders|
|UTAS Author:||Wood, B (Mrs Brenda Wood)|
|UTAS Author:||van der Mei, IAF (Associate Professor Ingrid van der Mei)|
|UTAS Author:||Pittas, F (Dr Fotini Pittas)|
|UTAS Author:||Taylor, BV (Professor Bruce Taylor)|
|Web of Science® Times Cited:||126|
|Deposited By:||Menzies Institute for Medical Research|
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