Comorbid anxiety disorders and treatment of depression in people with multiple sclerosis.
OBJECTIVE
Anxiety is highly comorbid with depression, but little is known about the impact of anxiety disorders on the effectiveness of empirically supported psychotherapies for depression. We examined such outcomes for people with Multiple Sclerosis (MS) and depression, with versus without comorbid anxiety disorders.


METHODS
Participants with MS (N = 102) received 16 weeks of telephone-administered psychotherapy for depression and were followed for one year post-treatment.


RESULTS
Participants with comorbid anxiety disorders improved to a similar degree during treatment as those without anxiety disorders. Outcomes during follow-up were mixed, and thus we divided the anxiety diagnoses into distress and fear disorders. The distress disorder (GAD) was associated with elevated anxiety symptoms during and after treatment. In contrast, fear disorders (i.e., panic disorder, agoraphobia, social phobia, specific phobia) were linked to depression, specifically during follow-up, across 3 different measures.


CONCLUSIONS
People with GAD receiving treatment for depression may benefit from additional services targeting anxiety more specifically, while those with comorbid fear disorders may benefit from services targeting maintenance of gains after treatment.
Burns
Michelle Nicole
MN
Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1220, Chicago, IL 60611, USA. mcobb03@yahoo.com
Siddique
Juned
J
Fokuo
J Konadu
JK
Mohr
David C
DC
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications* / Q000628:therapy; D003863:Depression / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D011613:Psychotherapy; D013689:Telephone; D016896:Treatment Outcome
Arch Gen Psychiatry. 2005 Sep;62(9):1007-14
16143732
Mult Scler. 2001 Aug;7(4):237-42
11548983
J Psychiatr Res. 1990;24(4):335-50
2090831
Arch Neurol. 1992 Mar;49(3):238-44
1536625
Annu Rev Psychol. 1998;49:377-412
9496627
J Affect Disord. 2007 Nov;103(1-3):113-20
17292480
Arch Neurol. 1997 May;54(5):531-3
9152109
Eur J Neurol. 2008 Mar;15(3):239-45
18215155
Mult Scler. 1999 Aug;5(4):223-33
10467380
Neurology. 1996 Mar;46(3):628-32
8618657
Arch Neurol. 2001 Jul;58(7):1081-6
11448297
Am J Psychiatry. 2008 Mar;165(3):342-51
18172020
J Rehabil Res Dev. 2003 May-Jun;40(3):265-82
14582530
Clin Psychol (New York). 2008;15(3):243-253
21369344
Psychiatr Serv. 1998 Aug;49(8):1086-8
9712219
J Affect Disord. 2003 Dec;77(3):247-54
14612224
Int J Epidemiol. 1994 Feb;23(1):148-54
8194911
Cogn Behav Ther. 2009;38 Suppl 1:29-34
22946137
Behav Res Ther. 2003 May;41(5):509-28
12711261
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
6880820
J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
14399272
Mult Scler. 2007 Jan;13(1):67-72
17294613
Disabil Rehabil. 2006 Mar 15;28(5):307-14
16492625
Am J Psychiatry. 1996 Oct;153(10):1293-300
8831437
Neurology. 2002 Sep 10;59(5):674-8
12221156
J Affect Disord. 2010 Jun;123(1-3):181-7
19733912
Behav Res Ther. 2008 Oct;46(10):1151-9
18687420
J Psychiatr Res. 1993 Jul-Sep;27(3):247-52
8295157
Depress Anxiety. 2008;25(4):282-8
18415951
Behav Ther. 2008 Jun;39(2):117-25
18502245
Behav Ther. 2016 Nov;47(6):838-853
27993336
J Abnorm Psychol. 2005 Nov;114(4):522-36
16351375
JAMA. 2003 Jun 18;289(23):3095-105
12813115
Psychol Bull. 1992 Jul;112(1):155-9
19565683