Depression and anxiety in a Portuguese MS population: Associations with physical disability and severity of disease

Abstract Background Mood disorders, namely depression and anxiety, have been well documented in patients with Multiple Sclerosis (MS). However, the putative associations between clinical features and mood disorders have not been well established. Objectives To detect anxiety and depression in MS patients; and to investigate possible associations with clinical factors. Subjects and methods 325 consecutive patients with MS and 183 healthy subjects answered the Hospital Anxiety and Depression Scale (HADS), a self-rating questionnaire. Multiple Regression Analysis and Multivariate Analysis of Covariance were applied to assess the effect of demographic and clinical factors on HADS' anxiety and depression scores, using age and disease duration as covariates. Logistic Regression Analysis was used to study the influence of these factors on anxiety and depression, as defined by two different cut-off scores (i.e., 8 and 11). Results Levels of anxiety and depression were significantly higher (p < 0.001) for MS patients group than healthy subjects. Age, disease duration, age at onset, Kurtzke Expanded Disability Status Scale, and Multiple Sclerosis Severity Scale were positively associated with depression scores. Low education (i.e., < 9 years) in MS was significantly associated with more anxiety and depression symptoms. Conclusions The study findings support a close linkage between depressive mood and physical manifestations of MS.