Anxiety, depression and fatigue at 5‐year review following CNS demyelination. (12th January 2016) - Simpson, S.
Abstract : Background: Anxiety and depression are common in multiple sclerosis (MS). We evaluated the prevalence and factors associated with anxiety, depression and fatigue at the 5‐year review of a longitudinal cohort study following a first clinical diagnosis of CNS demyelination (FCD). Methods: Cases with a FCD were recruited soon after diagnosis and followed annually thereafter. A variety of environmental, behavioural and clinical covariates were measured at five‐year review. Anxiety and depression were measured using the Hospital Anxiety & Depression Scale (HADS), and fatigue by the Fatigue Severity Scale (FSS). Results: Of the 236 cases, 40.2% had clinical anxiety (median HADS‐A: 6.0), 16.0% had clinical depression (median HADS‐D: 3.0), and 41.3% had clinical fatigue (median FSS: 4.56). The co‐occurrence of all three symptoms was 3.76 times greater than expectation. Younger age, higher disability, concussion or other disease diagnosis were independently associated with a higher anxiety score; male sex, higher disability, being unemployed, less physical activity, and antidepressant and/or anxiolytic‐sedative medication use were independently associated with a higher depression score. Higher disability, immunomodulatory medication use, other disease diagnosis and anxiolytic‐sedative medication use were independently associated with having fatigue, while female sex, higher BMI, having had a concussion, being unemployed and higher disability were associated with a higher fatigue score. Conclusion: These results support previous findings of the commonality of anxiety, depression and fatigue in established MS and extend this to post‐FCD and early MS cases. The clustering of the three symptoms indicates that they may share common antecedents.