title: Longitudinal assessment of anxiety, depression, and fatigue in people with multiple sclerosis.
abstract: OBJECTIVE
  No longitudinal studies have concurrently evaluated predictors of anxiety, depression, and fatigue in people with multiple sclerosis (PwMS). This study determined factors that best predicted anxiety, depression, and fatigue in MS patients from a large pool of disease, cognitive, life-event stressor (LES), psychosocial, life-style, and demographic factors.
  
  
  METHODS
  A 2-year prospective longitudinal study evaluated predictors of psychological distress and fatigue in PwMS.
  
  
  METHODS
  One hundred and one consecutive participants with MS were recruited from two MS clinics in Sydney, Australia. LES, anxiety, depression, and fatigue were assessed at baseline and at 3-monthly intervals for 2-years. Disease, cognitive, demographic, psychosocial, and life-style factors were assessed at baseline. Patient-reported relapses were recorded and corroborated by neurologists or evaluated against accepted relapse criteria.
  
  
  RESULTS
  Depression strongly predicted anxiety and fatigue, and anxiety and fatigue strongly predicted later depression. Psychological distress (i.e. anxiety, depression) was also predicted by a combination of unhealthy behaviours (e.g. drug use, smoking, no exercise, or relaxation) and psychological factors (e.g. low optimism, avoidance coping), similar to the results of community-based studies. However, state-anxiety and fatigue were also predicted by immunotherapy status, and fatigue was also predicted by LES and demographics.
  
  
  CONCLUSIONS
  These results suggest that similar factors might underpin psychological distress and fatigue in MS patients and community-well samples, although MS treatment factors may also be important. These results might assist clinicians in determining which MS patients are at greatest risk of developing anxiety, depression, or fatigue.
authors: School of Psychology, University of New England, Armidale, New South Wales, Australia. rhonda.brown@une.edu.au
authors: R F
authors: RF
authors: Brown
authors: E M
authors: EM
authors: Valpiani
authors: C C
authors: CC
authors: Tennant
authors: S M
authors: SM
authors: Dunn
authors: M
authors: M
authors: Sharrock
authors: S
authors: S
authors: Hodgkinson
authors: J D
authors: JD
authors: Pollard
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004185:Disability Evaluation; D005221:Fatigue / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies; D011584:Psychology; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology; D012944:Social Support; D011795:Surveys and Questionnaires