Prevalence, treatment and correlates of depression in multiple sclerosis

• DOI: 10.1016/j.msard.2024.105648
• Publication Date: 2024-04-26T15:44:36Z
• Authors: Carolyn A Young; Dawn Langdon; David Rog; Suresh Kumar Chhetri; Radu Tanasescu; Seema Kalra; Gillian Webster; Richard Nicholas; Helen L Ford; John Woolmore; David Paling; Alan Tennant; Roger Mills
• Keywords: Depression

Background The prevalence of depression in Multiple Sclerosis (MS) is often assessed by administering patient reported outcome measures (PROMs) examining depressive symptomatology to population cohorts; a recent review summarised 12 such studies, eight which used the Hospital Anxiety and Depression Scale-Depression (HADS-D). In clinical practice, diagnosed an individual structured interview; diagnosis leads treatment options including antidepressant medication. It follows that MS will include those whose current symptoms meet threshold for diagnosis, plus who previously met diagnostic criteria have been treated improved below threshold. We examined large establish multi-attribute estimate depression, taking into account probable on HADS-D, as well anti-depressant medication use co-morbidity data reporting depression. then studied associations with demographic health status trajectories over time. Methods Participants were recruited UK-wide Trajectories Outcome Neurological Conditions-MS (TONiC-MS) study, disease from records, PROMs collected at intervals least 9 months, co-morbidities Interval level conversions PROM followed Rasch analysis. Logistic regression characteristics Finally, group-based trajectory model was applied Results Baseline 5633 participants showed be 25.3% (CI: 24.2-26.5). There significant differences subtype: relapsing 23.2% 21.8- 24.5), primary progressive 25.8% 22.5-29.3), secondary 31.5% 29.0-34.0); disability: EDSS 0-4 19.2% 17.8-20.6), ≥4.5 31.9% 30.2-33.6); age: 42-57 years 27.7% 26.0-29.3), above or this range 23.1% 21.6-24.7). Fatigue, disability, self-efficacy self esteem correlated effect size (>.8) whereas sleep, spasticity pain, vision bladder had >.5. logistic (N=4938) correctly classified 80% 93% specificity: risk increased fatigue, anxiety, more comorbidities smoking. Higher marriage reduced Trajectory analysis 40 months (N=1096) three groups: 19.1% low symptoms, 49.2% greater between possible 31.7% high symptoms. 29.9% 27.6-32.3) depressed subjects untreated, conversely treated, 26.1% still symptom consistent case 23.5-28.9). Conclusion A essential because using only screening questionnaires, diagnoses all under-estimate true prevalence. affects MS, almost half either untreated indicating despite treatment. Services must pro-active flexible, recognising heterogeneity outcomes reaching out ongoing