Aim To examine the presence of depressive symptoms in patients with multiple sclerosis relapse and its relation to disability and relapse severity. Methods This study included 120 patients who were assessed during the acute relapse of multiple sclerosis according to Mc Donald criteria. Depression was assessed using Beck Depression Inventory II (BDI-II) calculating both affective and somatic symptom scores. The Expanded Disability Status Scale (EDSS) measured disability. Relapse severity was graded according to the difference between the EDSS score during relapse and EDSS score before the onset of the attack as mild, moderate or severe. Results There was statistically significant difference between patients with different level of depression considering age (p<0.001), disability (p<0.001), relapse severity (p=0.005) and disease duration (p=0.032). Significant moderate positive correlation of depression with age (rho=0.43) and disability (rho=0.46) was confirmed. There was moderate correlation between disability and somatic symptoms of depression (rho=0.54, p<0.001) with only weak correlation between disability and affective symptoms of depression (rho=0.31, p<0.01). Multiple regression analysis showed that patient’s age and relapse severity (p<0.05) were independently related to depression in these patients while disability did not. Conclusion Correlation between disability and depression was mostly due to somatic symptoms of depression. Although highly correlated, depression during multiple sclerosis relapse was not independently predicted by disability. Depression should be recognized and treated independently from disability treatment, especially in the group of older patients with more severe relapse.
Feinstein A, Magalhaes S, Richard J, Audet B, Moore C. The link between multiple sclerosis and depression. Nat Rev Neurol. 2014. p. 507–17.
2.
Feinstein A. Multiple sclerosis and depression. Mult Scler. 2011. p. 1276–81.
3.
Marrie R, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T. The burden of mental comorbidity in multiple sclerosis: frequent, underdiagnosed, and undertreated. Mult Scler. 2009. p. 385–92.
4.
Consensus G, Group. The Goldman Consensus statement on depression in multiple sclerosis. Mult Scler. 2005. p. 328–37.
5.
Patten S, Berzins S, Metz L. Challenges in screening for depression in multiple sclerosis. Mult Scler. 2010. p. 1406–11.
6.
Chwastiak L, Ehde D, Gibbons L, Sullivan M, Bowen M, Kraft J, et al. Depressive symptoms and severity of illness in multiple sclerosis. Epidemiologic study of a large community sample. AM J Psychiatry. 2002. p. 1862–8.
7.
Siegert R, Abernethy D. Depression in multiple sclerosis: a review. J Neurol Neurosurg Psychiatry. 2005. p. 469–75.
8.
Ivanova J, Bergman R, Birnbaum R, Phillips H, Stewart A, Meletiche M, et al. Impact of medication adherence to disease-modifying drugs on severe relapse, and direct and indirect costs among employees with multiple sclerosis in the US. J Med Econ. 2012. p. 601–9.
9.
Ensari I, Motl R, Mcauley E, Mullen S. Feinstein A. Patterns and predictors of naturally occurring change in depressive symptoms over a 30-month period in multiple sclerosis. Mult Scler. 2014. p. 602–9.
10.
Shen Y, Bai L, Gao Y, Fi C, Tan Z, Tao Y, et al. Depressive symptoms in multiple sclerosis from an in vivo study with TBSS. Bio Med Res Int. 2014. p. 148465.
11.
Diagnostic and Statistical Manual of Mental Disorders -DSM-IV-TR. American Psychiatric Publishing Inc; 2000.
12.
Skokou M, Soubasi E, Gourzis F. Depression in multiple sclerosis: a review of assessment and treatment approaches in adult and pediatric populations. Neurology. 2012. p. 427102.
13.
Feinstein A. An examination of suicidal intent in patients with multiple sclerosis. Neurology. 2002. p. 674–8.
14.
Polman C, Reingold S, Edan G, Filippi M, Hartung H, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the ’ ’McDonald Criteria. Ann Neurol. 2005. p. 840–6.
15.
Burnes M, Nawacki E, Siddique J, Pelletier D, Mohr D. Prospective examination of anxiety and depression before and during confirmed and pseudo-exacerbations in patients with Multiple Sclerosis. Psychosom Med. 2013. p. 76–82.
16.
Kurtzke J. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983. p. 1444.
17.
Mowry E, Pesic M, Grimes B, Deen S, Bacchetti P, Waubant B. Demyelinating events in early multiple sclerosis have inherent severity and recovery. Neurology. 2009. p. 602–8.
18.
Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961. p. 561–71.
19.
Minden S, Feinstein A, Kalb R, Miller D, Mohr D, Patten S, et al. Evidence based guideline: assessment and management of psychiatric disorders in individuals with MS: report of the Guideline Development Subcommittee of the. Neurology. American Academy of Neurology; 2014. p. 174–81.
20.
Delisle V, Beck A, Dobson K, Dozois D, Thombs B. Revisiting gender differences in somatic symptoms of depression: much ado about nothing? PLoS One. 2012. p. 32490.
21.
Jones K, Ford D, Jones P, John A, Middleton R, Lockhart-Jones H, et al. A large-scale study of anxiety and depression in people with multiple sclerosis: a survey via the web portal of the UK MS Register. PLoS One. 2012. p. 41910.
22.
Leach L, Christensen H, Mackinnon A, Windsor T, Butterworth P. Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Soc Psychiatry Psychiatr Epidemiol. 2008. p. 983–98.
23.
Alsaadi T, Hammasi E, Shahrour K, Shakra T, Turkawi M, Mudhafar L, et al. Prevalence of depression and anxiety among patients with multiple sclerosis attending the MS clinic at Sheikh Khalifa Medical City, UAE: cross-sectional study. Mult Scler Int. 2015. p. 487159.
24.
Mohammadi K, Rahnama P, Montazeri A. Prevalence and risk factors for depression in women with multiple sclerosis: a study from Iran. Ann Gen Psychiatry. 2015. p. 14–29.
25.
Nickerson M, Cofield S, Tyry T, Salter A, Cutter G, Marrie R. Impact of multiple sclerosis relapse: The NARCOMS participant perspective. MS Relat Disord. 2015. p. 234–40.
26.
Marrie R, Cutter G, Tyry T. Substantial burden of dizziness in multiple sclerosis. MS Relat Disord. 2012. p. 21–8.
27.
Kirchner T, Lara S. Stress and depression symptoms in patients with multiple sclerosis: the mediating role of the loss of social functioning. Acta Neurol Scand. 2011. p. 407–13.
28.
Jones K, Jones P, Middleton R, Ford D, Tuite-Dalton K, Lockhart-Jones H, et al. Physical Disability, Anxiety and Depression in People with MS: An Internet-Based Survey via the UK MS Register. PLoS ONE. 2014. p. e104604.
29.
Jones K, Ford D, Jones P, John A, Middleton R, Lockhart-Jones H, et al. The physical and psychological impact of Multiple Sclerosis using the MSIS-29 via the web portal of the UK MS Register. PLoS One. 2013. p. 55422.
30.
Lynch S, Kroencke D, Denney D. The relationship between disability and depression in multiple sclerosis: the role of uncertainty, coping, and hope. Mult Scler. 2001. p. 411–6.
31.
Tadić D, Đajić V. Quality of life in patients with multiple sclerosis in Republic of Srpska. Med Glas (Zenica). 2013. p. 113–9.
32.
Stojanović-Tasić M, Grgurević A, Cvetković J, Grgurević U, Trajković G. Association between somatic diseases and symptoms of depression and anxiety among Belgrade University students. Med Glas (Zenica). 2014. p. 373–8.
33.
Fischer A, Fischer M, Nicholls R, Lau S, Poettgen J, Patas K, et al. Diagnostic accuracy for major depression in multiple sclerosis using self-report questionnaires. Brain and Behavior. 2015. p. 365.
34.
Depresija u toku relapsa multiple skleroze: povezanost sa fizičkim onesposobljenjem i težinom relapsa Selma Šabanagić-Hajrić 1 , Enra Suljić 1. Gorana Sulejmanpašić-Arslanagić.
35.
1 Neurološka klinika, 2 Psihijatrijska klinika; Univerzitetski klinički centar, Sarajevo, Bosna i Hercegovina SAŽETAK Cilj Evaluirati prisustvo depresivnih simptoma u toku relapsa multiple skleroze i njihovu povezanost s onesposobljenjem i težinom relapsa.
36.
Težina relapsa je procijenjena na osnovu razlike EDSS-skora u toku i prije relapsa.
37.
Rezultati Uočena je statistički signifikantna razlika između pacijenata s različitim stupnjem depresije u odnosu na dob (p<0,001), onesposobljenost (p<0,001), težinu relapsa (p=0,005) i dužinu trajanja bolesti (p=0.032).
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
