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Type: Journal article
Title: Anxiety, depression and fatigue at 5-year review following CNS demyelination
Author: Simpson, S.
Tan, H.
Otahal, P.
Taylor, B.V.
Ponsonby, A.L.
Lucas, R.M.
Blizzard, L.
Valery, P.C.
Lechner-Scott, J.
Shaw, C.
Williams, D.
van der Mei, I.
Citation: Acta Neurologica Scandinavica, 2016; 134(6):403-413
Publisher: Wiley
Issue Date: 2016
ISSN: 0001-6314
Statement of
S. Simpson, H. Tan, P. Otahal, B. Taylor, A.-L. Ponsonby, R.M. Lucas, L. Blizzard, P.C. Valery, J. Lechner-Scott, C. Shaw, D. Williams, Ausimmune/AusLong Investigators Group, I. van der Mei, Keith Dear
Abstract: 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 HADSA: 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.
Keywords: Multiple sclerosis; prevalence; anxiety; depression; fatigue; first demyelinating event
Rights: © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
DOI: 10.1111/ane.12554
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