Showing papers on "Psychiatric interview published in 2021"

Assessing psychopathology in bariatric surgery candidates: discriminant validity of the SCL-90-R and SCL-K-9 in a large sample of patients

Abstract: Pre-surgical psychosocial evaluation of bariatric surgery (BS) patients should identify psychiatric issues that could worsen after surgery and those requiring additional ongoing intervention. In this view, the use of reliable, appropriate and concise evaluating instruments is of critical importance. The aim of the present study was to investigate the clinical utility of both the Symptom Checklist 90-Revised (SCL-90-R) and its brief unidimensional version, the so-called Symptom-Checklist-K-9 (SCL-K-9) in detecting the presence of psychiatric disorders among bariatric surgery (BS) candidates. Seven-hundred-and-ninety-eight BS candidates (563 women and 235 men; mean age: 44.15 ± 11.45) were enrolled in the present study. All participants underwent a full psychiatric interview and were administered the SCL-90-R. Three-hundred-and-sixty-two patients (45.4%) met the criteria for a diagnosis of at least one psychiatric disorder and ninety-nine patients (12.4%) had psychiatric comorbidities. In the current sample, 219 patients (27.4%) met the criteria for binge eating disorders (BED), 158 (19.8%) met the criteria for major depressive disorder (MDD), and 67 (8.4%) met both criteria. A receiver operating characteristic (ROC) curves procedure showed that both the SCL-90-R and the SCL-K-9 satisfactorily categorize patients with any psychiatric disorder, both BED and MDD (area under the ROC curve ≥ 0.70, p < 0.001). Our results suggest that the SCL-90-R and the SCL-K-9 may represent first-level screening tests identifying at-risk patients, eligible for a more expensive or time-consuming clinical assessment. Level V, cross-sectional, descriptive study.

Mid-term Psychiatric Outcomes of Patients Recovered From COVID-19 From an Italian Cohort of Hospitalized Patients

Abstract: Background: Although the usual primary clinical manifestation of Coronavirus disease (COVID-19) is respiratory, several non-respiratory symptoms have been described, including neuropsychiatric ones. The aim of this study was to investigate the mid-term mental health outcomes in patients recovered from COVID-19, 3-4 months after discharge from the University Hospital Maggiore della Carita, Novara, Italy. Furthermore, we investigated the possible association of the mid-term mental health consequences of the COVID-19 infection with patients' clinical current status, persistent physical impairment and severity of acute phase of the disease. Methods: Prospective study involving 238 individuals recovered from COVID-19. In the context of a multi-disciplinary approach, patients' assessment included both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview to assess the presence of anxiety and depressive symptoms and self-administered questionnaires: Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Resilience Scale for Adults (RSA), Impact of Event Scale (IES). Results: At the psychiatric assessment 32.9 and 29.5% of participants showed anxiety and depressive symptoms, respectively. Changes in appetite and sleep patterns emerged for 15.6 and 31.2% of patients. According to the self-administered questionnaires, 7.1% of participants had moderate-severe anxiety levels (BAI), while 10.5% had mild to severe depression (BDI-II). Twenty-six (11%) participants were referred to further psychiatric consultation. Psychiatric symptoms showed no correlation with acute COVID-19 severity; in our sample patients with depressive symptoms at the clinical interview, as well as those with mild to severe levels of depression according to BDI-II scores, had lower forced expiratory volume in the 1st second (FEV1) values than those without and greater odds for persistent, poor tolerance for physical efforts. Conclusions: As could be expected, an approach including both a psychiatric interview and the use of self-administered questionnaires is likely to capture the psychiatric outcome of patients recovered from COVID-19 better than questionnaires alone. Anxiety and depressive symptoms at follow-up had no correlation with the severity of COVID acute manifestations, but rather with ongoing and persistent physical symptoms. Further studies and longer follow-up duration will allow a better understanding of the complex relationship between residual physical symptoms, quality of life and psychological health.

Revisiting False-Positive and Imitated Dissociative Identity Disorder.

Abstract: ICD-10 and DSM-5 do not provide clear diagnosing guidelines for DID, making it difficult to distinguish ‘genuine’ DID from imitated or false-positive cases. This study explores meaning which patients with false-positive or imitated DID attributed to their diagnosis. 85 people who reported elevated levels of dissociative symptoms in SDQ-20 participated in clinical assessment using the Trauma and Dissociation Symptoms Interview, followed by a psychiatric interview. The recordings of six women, whose earlier DID diagnosis was disconfirmed, were transcribed and subjected to interpretative phenomenological analysis. Five main themes were identified: (1) endorsement and identification with the diagnosis. (2) The notion of dissociative parts justifies identity confusion and conflicting ego-states. (3) Gaining knowledge about DID affects the clinical presentation. (4) Fragmented personality becomes an important discussion topic with others. (5) Ruling out DID leads to disappointment or anger. To avoid misdiagnoses, clinicians should receive more systematic training in the assessment of dissociative disorders, enabling them to better understand subtle differences in the quality of symptoms and how dissociative and non-dissociative patients report them. This would lead to a better understanding of how patients with and without a dissociative disorder report core dissociative symptoms. Some guidelines for a differential diagnosis are provided.

Quality of life and psychopathology in candidates to bariatric surgery: relationship with BMI class.

Abstract: This cross-sectional study aimed at comparing the quality of life (Qol), the prevalence of psychiatric diagnosis and pharmacological treatment in 104 candidates to bariatric surgery according to the degree of obesity (class 2 vs. class ≥ 3 obesity). All surgical candidates underwent a detailed psychiatric interview based on DSM-5 criteria, including sociodemographic, clinical, psychological and psychiatric data. Participants completed the Binge Eating Scale (BES) and the 12-Item Short Form Health Survey (SF-12). Overall, bariatric candidates reported a significant impairment in the physical (PCS 38.8 [95% CI 36.2–41.5]) and mental (MCS 42.2 [95% CI 40.4–43.9]) components of Qol compared to population norms (p < 0.001 for both). Subjects with class 2 obesity scored significantly lower in the MCS compared to those with class 3 (38.7 (8.1) vs. 43.6 (8.4), p = 0.008). No other statistically significant differences were found between the two groups in terms of sociodemographic and clinical variables. These data support the usefulness of Qol assessment in bariatric candidates as a sensible screening parameter, especially in patients with lower BMI, in whom MCS could identify the need for early psychosocial intervention. Level III, case-control analytic study.

Measuring Knowledge, Attitudes, and Barriers to Medication Adherence in Potential Bariatric Surgery Patients.

Abstract: Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery. The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations. Attitude to adherence was associated with alexithymia (β = ˗2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = −2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale. We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done.

The Impact of Wearing a Face Mask on the Psychiatric Interview: a National Survey During the COVID-19 Pandemic.

Abstract: The COVID-19 pandemic has forced to rapidly encourage the use of face masks during medical consultations, with significant implication for psychiatry. This study examined the opinions and attitudes of psychiatrists toward the impact of wearing a face mask on the psychiatric interview. 513 psychiatrists and trainee psychiatrists completed an electronic survey about the impact of wearing a face mask on the psychiatric interview. Less efficiency in capturing clinical signs/symptoms, emergence of false inferences in patients and altered patient-clinician interactions were commonly reported negative impacts of face mask (66-96%). The quality of the therapeutic alliance was reported as affected by the mask by 47% of the sample. Results were mixed on the use of telepsychiatry as a potential solution to mask-related inconvenience. The use of face masks has significant negative effects on the psychiatric interview. Providing specific training to clinicians could be a potential solution for masks-induced biases.

Non-Suicidal Self-Injury Among Incarcerated Adolescents: Prevalence, Personality, and Psychiatric Comorbidity.

Abstract: Introduction: Incarcerated adolescents represent a risk group for non-suicidal self-injury (NSSI), but research on this population has been limited and no studies have been conducted in Russia. To address this deficit, this study examined NSSI and the factors associated with it among youth in a juvenile correctional facility in Russia. Methods: NSSI and psychopathology were assessed using a psychiatric interview and self-report questionnaire in 368 incarcerated male adolescents aged 14-19 years (mean age 16.4 years, S.D. 0.9) from Northern Russia. Results: 18.2% (N = 67) of the study participants had a history of NSSI and also had higher rates of anxiety, post-traumatic stress disorder (PTSD), depression, community violence exposure and scored higher on most of the Youth Self-Report problem scales. In addition, 31.3% of the NSSI group reported previous suicidal ideation and had thought about a specific suicide method compared to 12.0% in the No-NSSI group. Adolescents with NSSI also differed significantly from the No-NSSI group on self-directedness (lower) and self-transcendence (higher) personality traits. Conclusion: NSSI is common in incarcerated adolescents in Russia and is associated with extensive psychiatric comorbidity, suicidal ideation and specific personality traits.

Guidelines for the design of a virtual patient for psychiatric interview training

Abstract: A psychiatric diagnosis involves the physician’s ability to create an empathic interaction with the patient in order to accurately extract symptomatology (i.e., clinical manifestations). Virtual patients (VPs) can be used to train these skills but need to propose a structured and multimodal interaction situation, in order to simulate a realistic psychiatric interview. In this study we present a simulated psychiatric interview with a virtual patient suffering from major depressive disorders. We suggested some design guidelines based on psychiatry theories and medicine education standards. We evaluated our VP with user testing with 35 4th year medical students, and probed their opinion during debriefing interviews. All students showed good abilities to communicate empathetically with the VP, and managed to extract symptomatology from VP’s simulation. Students provided positive feedbacks regarding pedagogic usefulness, realism and enjoyment in the interaction, which suggests that our design guidelines are consistent and that such technologies are acceptable to medical students. To conclude this study is the first to simulate a realistic psychiatric interview and to measure both skills needed by future psychiatrists: symptomatology extraction and empathic communication. Results provide evidence for the use of VPs to complement existing tools and to train and evaluate healthcare professionals in the future.

Rates of Assessment of Social Media Use in Psychiatric Interviews Prior to and During COVID-19: Needs Assessment Survey

Abstract: Background: Current research suggests that there is a nuanced relationship between mental well-being and social media. Social media offers opportunities for empowerment, information, and connection while also showing links with depression, high-risk behavior, and harassment. As this medium rapidly integrates into interpersonal interactions, incorporation of social media assessment into the psychiatric evaluation warrants attention. Furthermore, the COVID-19 pandemic and containment measures (ie, social distancing) led to increased dependence on social media, allowing an opportunity to assess the adaptation of psychiatric interviews in response to sociocultural changes. Objective: The first aim of this study was to evaluate if general psychiatry residents and child and adolescent psychiatry fellows assessed social media use as part of the clinical interview. Second, the study examined whether changes were made to the social media assessment in response to known increase of social media use secondary to social distancing measures during the COVID-19 pandemic. Methods: As part of a quality improvement project, the authors surveyed general psychiatry residents and child psychiatry fellows in a university-based training program (n=21) about their assessment of social media use in patient evaluations. Soon after the survey closed, “stay-at-home” orders related to the COVID-19 pandemic began. A subsequent survey was sent out with the same questions to evaluate if residents and fellows altered their interview practices in response to the dramatic sociocultural changes (n=20). Results: Pre-COVID-19 pandemic survey results found that 10% (2/21) of respondents incorporated social media questions in patient evaluations. In a follow-up survey after the onset of the pandemic, 20% (4/20) of respondents included any assessment of social media use. Among the 15 participants who completed both surveys, there was a nonsignificant increase in the likelihood of asking about social media use (2/15, 13% vs 4/15, 27%, for pre- and during COVID-19, respectively; McNemar χ21=0.25, P=.617, Cohen d=0.33). Conclusions: These small survey results raise important questions relevant to the training of residents and fellows in psychiatry. The findings suggest that the assessment of social media use is a neglected component of the psychiatric interview by trainees. The burgeoning use and diversity of social media engagement warrant scrutiny with respect to how this is addressed in interview training. Additionally, given minimal adaptation of the interview in the midst of a pandemic, these findings imply an opportunity for improving psychiatric training that incorporates adapting clinical interviews to sociocultural change.

Psychiatry Clinical Skills Evaluation: a Multisite Study of Validity

Abstract: Since 2007, the American Board of Psychiatry and Neurology (ABPN) has required that residency programs conduct a specific clinical skills evaluation (CSE) of physician-patient interaction, psychiatric interview and mental status examination, and case presentation on a directly observed patient interview as a prerequisite for certification. The authors examined a multisite database of CSE assessments to investigate the validity of the evaluation. The authors collected 1156 CSE assessments from 4 residency programs conducted over a 6-year period, compared scoring patterns among the programs, score improvement over 4 years of residency, time and number of CSEs required to meet ABPN requirements, and patterns of scoring for individual faculty evaluators. The distribution of scores within each of the 4 programs showed similar, but nonidentical patterns. The number of CSEs required to meet the ABPN standards (3.5) and the point in training at which this was completed (late PGY-2) were the same in all programs. CSE scores were highly correlated with year of training but were not correlated with performance on an unrelated cognitive examination. Individual faculty members tended to stay within a moderate range of scores over multiple residents, partially attributable to year of training. Taken together, these findings support the validity of the CSE as a measure of residents’ clinical skills in the specified areas and demonstrate a moderate-high degree of consistency in the scoring of the CSE across these 4 programs.

A Hierarchical Ontology for Dialogue Acts in Psychiatric Interviews

Abstract: We present our work on modeling the context of an interview during diagnostic sessions for patients with mental health problems. The results are to be exploited by translation system for telehealth services. More specifically, we plan to use the context of the psychiatric interview in order to set informative priors over the vocabulary of the speaker. Therefore we have modelled the context with a hierarchical ontology, and we use it to classify the current state of the interview. The state is extracted after the doctor asks a question, and allow us to select a non-uniform prior regarding the vocabulary of the patient.

KSADS-COMP Perspectives on Child Psychiatric Diagnostic Assessment and Treatment Planning.

Abstract: Gibbons et al.1 demonstrated the utility of computerized adaptive tests (CATs) based on multidimensional item response theory for the assessment of depression, anxiety, mania/hypomania, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, and suicidality in children and adolescents. The Kiddie-Computerized Adaptive Test (K-CAT) demonstrated good convergent validity, test-retest reliability, and diagnostic concordance with diagnoses derived using the paper-and-pencil Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) child psychiatric interview.

Prevalence of psychiatric disorders in Norwegian 10-14-year-olds: Results from a cross-sectional study.

Abstract: Youth mental health problems is the leading cause of disability worldwide and a major public health concern. Prevalence rates are needed for planning preventive interventions and health care services. We here report Norwegian prevalence estimates for youth mental disorders based on findings from the Bergen Child Study cohort. A web-based psychiatric interview; the Development and Well-Being Assessment, was completed by parents and teachers of 2,043 10-14-year-olds from the city of Bergen, Norway. Post-stratification weights were used to account for selective participation related to parental educational in the estimation of prevalence rates. Prevalence rates are presented for the whole sample and stratified by gender and age. The overall population weighted estimate suggests that 6.93% (95% CI 5.06-9.41) of the children met DSM-IV diagnostic criteria for one or more psychiatric disorders. There were no robust indications of age- or gender-related differences in the prevalence. 11.4% of the children fulfilled criteria for more than one diagnosis. The most common comorbid conditions were ADHD and disruptive disorders. The prevalence of psychiatric disorders was relatively low among Norwegian 10-14-year-olds, compared to published worldwide prevalence estimates. This is in line with estimates from prior studies from the Nordic countries. These findings raise important questions about the origins of different prevalence rates for psychiatric disorders between societies. The findings also illustrate the importance of locally driven epidemiological studies for planning preventative efforts and appropriately scaling mental health services to meet the need of the population.

Psychiatric and Cognitive Morbidity Following Moderate and Severe SARS-CoV-2 Infection: A Cohort Study

Abstract: Background: Recent studies indicate that psychiatric and neurocognitive symptoms are frequent after Coronavirus Disease-2019 (COVID-19). The present study aims to investigate the occurrence of psychiatric and cognitive impairments in a cohort of survivors from moderate or severe forms of COVID-19. Methods: 425 adults (mean age 55.7 years) were assessed 6 to 9 months after hospital discharge with a structured psychiatric interview (Clinical Interview Schedule, CIS-R) and a combination of psychometric tests. Cognitive state was examined with a subjective memory complaint scale and screening tests. A large, multidisciplinary, set of clinical data depicting the acute phase of the disease, along with relevant psychosocial variables, were used to predict psychiatric and cognitive outcomes using the ‘Least Absolute Shrinkage and Selection Operator’ (LASSO) method. Outcomes: CIS-R diagnoses of ‘depression’, ‘generalized anxiety disorder’ and ‘post-traumatic stress disorder’ were established respectively in 8%, 15.5% and 13.6% of the sample. Memory decline was reported by 51.1% of the patients. Psychiatric or cognitive outcomes were not predicted by any clinical variables related to the severity of acute-phase disease, nor by disease-related psychosocial stressors. Rather, depression and anxiety were only predicted by current frailty and worse general health status. Interpretation: Using a structured psychiatric interview and an objective assessment of cognitive state, we found high rates of psychiatric and cognitive morbidity in the long-term outcome after moderate or severe COVID-19. The lack of associations of previous medical or psychosocial factors with these diagnoses suggests a direct, disease-related, mechanism in the pathophysiology of COVID-19 related psychiatric and cognitive impairments. Funding: This work was partially supported by donations from the general public under the HC-COMVIDA crowdfunding scheme (https://viralcure.org/c/hc) and the Fundacao Faculdade de Medicina (ALA). ARB receives scholarships and support from FAPESP, the Brazilian National Council of Scientific Development (CNPq-1B), University of Sao Paulo Medical School (FMUSP), the UK Academy of Medical Sciences (Newton Advanced Fellowship), and the International Health Cohort Consortium (IHCC). Conflict of Interest: Authors Declare no Conflict of Interest. Ethical Approval: This research protocol has been approved by the Ethics Committee at HCFMUSP (CAPPesq HC), and registered at the Brazilian Registry of Clinical Trials (ReBEC) under the registration number 4.270.242 (RBR-8z7v5wc) and will be reported according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement.

Through the lens of a woman with schizoaffective disorder: a case study

Abstract: Motivation/Background: Historically speaking, the distinction between manic-depressive disorders and schizophrenia finds itself in an unclear and vast spectrum bordered by the two illnesses. In this paper, we will present a case study that raises a question of diagnosis: bipolar disorder or schizoaffective disorder? Following the description of the symptoms and diagnosis criteria of each of the disorders, along with the personal data of the patient (the ones that are available to us), we will attempt analyzing the case as thoroughly as possible. The paper introduces the case of a 40-year-old woman who presents affective/mood related symptoms. Method: psychiatric evaluation, psychiatric interview, psychodynamic interview and psychodynamic interpretation. Results: The subject has a pathology of attachment developed over a structure with homosexual attachment choices. The multiple psychotraumas of childhood and the busy life history overlap with a vulnerability for emotional manifestations. She develops as axis I pathology a bipolar affective disorder, which at the moment takes the form of a mixed dispositional episode with psychotic phenomena. The artistic side makes it work markedly on delirious interpretativity, as it is to be appreciated the patient's effort not to completely detach from reality. Conclusions: Late detection of these habits by the relatives, as well as other signs of psychiatric conditions, has contributed to an alteration of the identity of the patient and an inability to develop proper social behavior. After an overview of the patient's life experience, we can presume that the psychiatric condition is present and that it is evolving. The aim of the paper is to provide a theoretical viewpoint on this specific pathology, with particular features for this case study

Mental Status Examination

Abstract: In this chapter, we review pertinent aspects of the mental status examination as part of the psychiatric interview of older adults.

The Perinatal Psychiatric Interview

Abstract: The basic principles of the perinatal psychiatric interview will be covered in detail in this chapter. The importance of establishing rapport and creating a therapeutic alliance will be reviewed. Details of the context of the interview, including thoughtful consideration of the setting, situation, subject and significance will be outlined. The content of the psychiatric interview will be covered in full, including the mental status examination. Attention regarding the conclusion of the interview and assessment, including coordination of care with other providers and areas of possible difficulty, will also be discussed.

The profile of subclinical hypothyroidism in subjects with premenstrual dysphoric disorder – A pilot study

Abstract: Background: Psychiatric disorders are usually found to be associated with thyroid dysfunction. Although thyroid dysfunction's relevance to psychiatric disorders is recognized, few studies have estimated the prevalence of subclinical hypothyroidism in subjects with the premenstrual dysphoric disorder in the Indian population. Method: A hospital-based cross-sectional study conducted in a tertiary care centre in central Kerala, enrolled 70 subjects diagnosed with Premenstrual Dysphoric Disorder (PMDD) who presented to the psychiatry and gynaecology Out Patient Departments (OPD). Sociodemographic and clinical data were collected followed by administration of PMDD rating scale. Mini International Psychiatric Interview was done to rule out other psychiatric disorders. TSH was done for all subjects after two months during follow up. Results: 63.33 % of subjects with PMDD were found to have thyroid dysfunction. A significant association was established between PMDD score and subclinical hypothyroidism. Conclusion: Subclinical hypothyroidism is common in premenstrual disorder and is closely associated with the same.

Histrionic immature personality disorder

Abstract: Background: We aim at presenting a clinical case of a 37-year-old patient, who has been a nun for several years and at the moment can no longer adapt to the environment in which she lives and to the requirements of everyday life. The perspective of this analysis is both a psychiatric one, explaining the diagnosis of Axis II of Histrionic Immature Personality Disorder, but also the overlap with dissociative conversion disorder, and explanatory from a psychodynamic perspective, by addressing the regression issues and the presence of the Oedipus Complex. Histrionic Immature Personality Disorder and its overlap with Dissociative/Conversion Disorder are conditions with negative effects in terms of adaptation to the social environment and assuming professional responsibilities. Also, the particularities in the sphere of immaturity make it difficult to relate to those around. Method: Hospitalization, psychiatric interview, psychodynamic interview, psychological tests - CAQ Personality Questionnaire and the Szondi Test, psychodynamic interpretations. Results: The results highlight aspects of an immature premorbid personality, characterized by a high degree of sensitivity. Currently, the patient's ego is fragile and cannot adapt to the emotional meanings in the environment in which she lives, which leads to functional crises and manifestations such as dissociative fugue. Conclusions: Dissociative manifestations are associated with immaturity and reduced ability to adapt to professional requirements. On a personal level, the same immaturity leads to the denial of one's sexuality and projection.

Interleukin 1 Beta Is Associated With Depression in Multiple Sclerosis Patients

Abstract: Depressive and anxiety symptoms occur more frequently in chronic encephalomyelitis. Inflammatory diseases are highly associated with psychiatric comorbidities, which has been well established in Multiple Sclerosis. However, no biomarkers have been found with the capacity to discern between MS and depression. Thirty-six individuals with a diagnosis of MS according to the revised McDonald criteria, were recruited from an outpatient Neurology and Psychiatry from the medical unit of high specialty in Mexico. We measured the association between BDNF, IL-1β, and TNFα in serum with the presence of depression and anxiety using the semi-structured psychiatric interview, the Beck Depression Inventory (IDB), and Hospital Anxiety and Depression Scale (HADS). This was a cross-sectional study. The Logistic Regression was used for the multivariate analysis adjusted by the Multiple Sclerosis Severity Score (MSSS). With a power of 0.75 in the final model, patients with multiple sclerosis, depression, and anxiety obtained the highest values of IL-1 β in our study.