Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis

TLDR: Anxiety, depression and fatigue are common in persons with multiple sclerosis and tend to cluster together, important for clinical management of PwMS and to the exploration of possible shared causal biological pathways.

Abstract: 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% ...