title: Depression and anxiety in a Portuguese MS population: associations with physical disability and severity of disease.
abstract: BACKGROUND
  Mood disorders, namely depression and anxiety, have been well documented in patients with Multiple Sclerosis (MS). However, the putative associations between clinical features and mood disorders have not been well established.
  
  
  OBJECTIVE
  To detect anxiety and depression in MS patients; and to investigate possible associations with clinical factors.
  
  
  METHODS
  325 consecutive patients with MS and 183 healthy subjects answered the Hospital Anxiety and Depression Scale (HADS), a self-rating questionnaire. Multiple Regression Analysis and Multivariate Analysis of Covariance were applied to assess the effect of demographic and clinical factors on HADS' anxiety and depression scores, using age and disease duration as covariates. Logistic Regression Analysis was used to study the influence of these factors on anxiety and depression, as defined by two different cut-off scores (i.e., 8 and 11).
  
  
  RESULTS
  Levels of anxiety and depression were significantly higher (p<0.001) for MS patients group than healthy subjects. Age, disease duration, age at onset, Kurtzke Expanded Disability Status Scale, and Multiple Sclerosis Severity Scale were positively associated with depression scores. Low education (i.e., <9 years) in MS was significantly associated with more anxiety and depression symptoms.
  
  
  CONCLUSIONS
  The study findings support a close linkage between depressive mood and physical manifestations of MS.
authors.affiliation: Neurology Department, Centro Hospitalar do Porto-Hospital de S. António (CHP-HSA), Porto, Portugal. anadmsilva@yahoo.com
authors.forename: Ana Martins
authors.initials: AM
authors.lastname: da Silva
authors.forename: Estela
authors.initials: E
authors.lastname: Vilhena
authors.forename: Alice
authors.initials: A
authors.lastname: Lopes
authors.forename: Ernestina
authors.initials: E
authors.lastname: Santos
authors.forename: Maria Alexandra
authors.initials: MA
authors.lastname: Gonçalves
authors.forename: Cláudia
authors.initials: C
authors.lastname: Pinto
authors.forename: Inês
authors.initials: I
authors.lastname: Moreira
authors.forename: Denisa
authors.initials: D
authors.lastname: Mendonça
authors.forename: Sara
authors.initials: S
authors.lastname: Cavaco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology*; D011174:Portugal / Q000453:epidemiology; D011788:Quality of Life; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult