title: Anxiety and depression in multiple sclerosis patients around diagnosis.
abstract: OBJECTIVE
  To prospectively identify anxiety and depressive symptoms, and their predictors, during the multiple sclerosis (MS) peridiagnostic period.
  
  
  METHODS
  The Hospital Anxiety and Depression Scale (HADS) was administered during diagnostic workup (baseline), and one and six months after diagnosis disclosure, to SIMS-Trial participants (ISRCTN81072971).
  
  
  RESULTS
  Of 197 screened patients, 120 (61%) were diagnosed with MS. At baseline, median HADS anxiety (HADS-A) score was 7.0 (interquartile range [IQR] 5.0-9.5), ≥8 (anxiety cut-off) in 43% (95% confidence interval [CI] 34%-52%). Median HADS depression (HADS-D) was 3.0 (IQR 1.0-5.0), ≥8 (depression cut-off) in 11% (95% CI 5%-16%). Independent predictors of anxiety were female sex (odds ratio [OR] 2.8, 95% CI 1.1-7.2) and HADS-D score (OR 20.8, 95% CI 2.5-175.5). The only predictor of depressive symptoms was HADS-A score (OR 20.0, 95% CI 2.8-260.9). Anxiety symptoms had decreased slightly but significantly (p<0.001) at six months. Depressive symptoms remained low.
  
  
  CONCLUSIONS
  Anxiety was prominent in the period surrounding MS diagnosis disclosure, particularly in women. A slight but significant reduction occurred six months after diagnosis disclosure. Depressive symptoms were less common and stable over time. In addition to sex, depressive symptoms were the only variable independently associated with anxiety.
authors.affiliation: Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Giordano
authors.forename: Franco
authors.initials: F
authors.lastname: Granella
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lugaresi
authors.forename: Vittorio
authors.initials: V
authors.lastname: Martinelli
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
authors.forename: Paolo
authors.initials: P
authors.lastname: Confalonieri
authors.forename: Davide
authors.initials: D
authors.lastname: Radice
authors.forename: Alessandra
authors.initials: A
authors.lastname: Solari
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D003943:Diagnostic Techniques, Neurological / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies