title: Variations in and predictors of the occurrence of depressive symptoms and mood symptoms in multiple sclerosis: a longitudinal two-year study.
abstract: BACKGROUND
  There is limited knowledge regarding how depressive symptoms and a cluster of specific mood symptoms in people with multiple sclerosis (MS) vary over time and how they are influenced by contributing factors. Therefore, the aims of this study were a) to describe variations over 2 years in the occurrence of depressive symptoms and mood symptoms in a sample of people with MS, and b) to investigate the predictive value of sex, age, coping capacity, work status, disease severity, disease course, fatigue, cognition, frequency of social/lifestyle activities, and perceived impact of MS on health, on the occurrence of depressive symptoms and mood symptoms.
  
  
  METHODS
  Through using a protocol of measures of functioning and perceived impact of MS on health, comprising of the Beck Depression Inventory, 219 people with MS were assessed at 0, 12 and 24 months. Predictive values were explored with Generalised Estimating Equations.
  
  
  RESULTS
  Proportions with depressive symptoms varied significantly (p < 0.001) from 21 to 30% between the three time points. Proportions with mood symptoms varied significantly (p < 0.001) from 14 to 17% between the three time points. Weak coping capacity and reduced frequency of social/lifestyle activities predicted the occurrence of depressive symptoms and mood symptoms, as did the psychological impact of MS on health in interaction with time. For people with MS of working age, not working predicted the occurrence of depressive symptoms and mood symptoms, as did the physical impact of MS on health on the occurrence of mood symptoms.
  
  
  CONCLUSIONS
  The occurrence of depressive symptoms and mood symptoms in people with MS vary over a 2-year time period; almost half have depressive symptoms at least once. Health care services should develop strategies aimed at identifying people with MS who are depressed or who develop depressive symptoms. Interventions for alleviating depressive symptoms should consider the individual's coping capacity and perceived impact of MS on health, and facilitate their ability to maintain participation in valued everyday activities.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden. sverker.johansson@ki.se.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. sverker.johansson@ki.se.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. sverker.johansson@ki.se.
authors.forename: Sverker
authors.initials: S
authors.lastname: Johansson
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden. kristina.gottberg@ki.se.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. kristina.gottberg@ki.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Gottberg
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden. marie.kierkegaard@ki.se.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. marie.kierkegaard@ki.se.
authors.forename: Marie
authors.initials: M
authors.lastname: Kierkegaard
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden. charlotte.ytterberg@ki.se.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. charlotte.ytterberg@ki.se.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. charlotte.ytterberg@ki.se.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ytterberg
mesh_terms: D000223:Adaptation, Psychological; D003071:Cognition; D003863:Depression / Q000453:epidemiology*; D018450:Disease Progression; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales