title: Physical disability, anxiety and depression in people with MS: an internet-based survey via the UK MS Register.
abstract: BACKGROUND
  People with Multiple Sclerosis are known to have a relatively high prevalence of both anxiety and depression. Studies of the relationship between physical disability and mental health in people with MS have reported mixed results, showing the need for further work.
  
  
  METHODS
  Between May 2011 and April 2012, 4516 people completed the MSIS-29 (v.1) and HADS scales via the dedicated internet site of the UK MS Register within a 7 day time window. These responses were linked with basic demographic and descriptive data and analysed in SPSS (v.20).
  
  
  RESULTS
  The proportions of people experiencing anxiety or depression increased with physical disability such that 38.0% of respondents with low, and 66.7% with high disability reported at least mild anxiety, and 17.1% of people with low, and 71.7% with high disability experienced at least mild depression. The multiple regression model explained 18.4% of the variance in anxiety with MSIS-29-PHYS score being the strongest predictor of anxiety. The model for depression explained 37.8% of the variance with MSIS-29-PHYS score being the strongest predictor. Some of the other variables included showed negative associations with anxiety and depression, indicating that the influence of physical disability on mental wellbeing could be underestimated.
  
  
  CONCLUSIONS
  This study indicates that there is a positive relationship between physical disability and anxiety and depression, that physical disability impacts on anxiety and depression to differing extents, and that the effects vary with gender, age, disease course and disease duration. We have shown that physical disability is a predictor of anxiety and depression, and that other factors may mask the extent of this effect. Whether the causes of anxiety and depression are reactive, organic or a combination, it is essential that mental wellbeing is given due attention in caring for people with MS so that all their health needs can be met.
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Kerina H
authors.initials: KH
authors.lastname: Jones
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Jones
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Rodden M
authors.initials: RM
authors.lastname: Middleton
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: David V
authors.initials: DV
authors.lastname: Ford
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Katie
authors.initials: K
authors.lastname: Tuite-Dalton
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Hazel
authors.initials: H
authors.lastname: Lockhart-Jones
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Peng
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Ronan A
authors.initials: RA
authors.lastname: Lyons
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: Ann
authors.initials: A
authors.lastname: John
authors.affiliation: College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
authors.forename: J Gareth
authors.initials: JG
authors.lastname: Noble
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D015995:Prevalence; D012042:Registries; D012044:Regression Analysis