title: Anxiety, depression and impaired health-related quality of life are therapeutic challenges in patients with multiple sclerosis.
abstract: Anxiety, depression and impaired health-related quality of life (HRQoL) are commonly reported in patients with multiple sclerosis (MS) and are of great interest for therapeutic approaches. Based on regional differences a quantitative assessment of these factors in comparison to the general population, and the consideration of demographic cofactors, would be useful when designing specific interventions. We adopted such an approach in a German cohort of MS patients. Anxiety, depression (HADS) and HRQoL (SF-36) were measured in 49 consecutive outpatients with MS and compared to age- and gender-adjusted control groups (n=1330 for HADS; n=5087 for SF-36) extracted from German National Health Surveys. Patients with MS showed significantly increased levels of anxiety and depression as well as decreased HRQoL with the exception of mental health; the effect sizes ranged from 0.39 (depression) to 1.06 (physical functioning). As could be expected, MS patients with relapsing-remitting clinical course had better physical functioning than patients with secondary progressive MS. There were strong relations between anxiety and depression (r=0.54; P<0.01), and between neurological impairment (EDSS) and physical functioning (r=-0.80; P<0.001) as well as depression (r=0.48; P<0.05). This investigation of MS patients confirms the prevalence and impact of anxiety, depression and most of the HRQoL dimensions in MS patients and provides evidence for the usefulness of a quantitative comparison to a region-specific general population as a starting point for therapeutic approaches.
authors.affiliation: Department of Neurology, University of Leipzig, Leipzig, Germany;
authors.forename: Dominik
authors.initials: D
authors.lastname: Michalski
authors.affiliation: Department of Neurology, University of Leipzig, Leipzig, Germany;
authors.forename: Stefanie
authors.initials: S
authors.lastname: Liebig
authors.affiliation: Department of Neurology, University of Leipzig, Leipzig, Germany; ; Translational Centre of Regenerative Medicine (TRM-Leipzig), University of Leipzig, Leipzig, Germany;
authors.forename: Eva
authors.initials: E
authors.lastname: Thomae
authors.affiliation: Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.affiliation: Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hinz
authors.affiliation: Department of Neurology, University of Leipzig, Leipzig, Germany; ; Translational Centre of Regenerative Medicine (TRM-Leipzig), University of Leipzig, Leipzig, Germany;
authors.forename: Florian Then
authors.initials: FT
authors.lastname: Bergh
keywords: anxiety; depression; health-related quality of life; multiple sclerosis.