title: The Relationship of Symptoms of Anxiety and Depression with Disease Severity and Treatment Modality in Myasthenia Gravis: A Cross-sectional Study.
abstract: BACKGROUND
  Findings about the relationship between psychopathology and severity of myasthenia gravis (MG) seem scarce and conflicting. The aim of this study was to investigate the relationship of depressive and anxiety symptoms with disease severity and treatment modalities among a cohort of patients with MG.
  
  
  METHODS
  Sixty-seven patients, who presented to the neuromuscular outpatient clinic, at a neuropsychiatry hospital in Istanbul, Turkey in a two-month period, were recruited consecutively. A total of 42 patients with MG were invited to participate in the study. None of the patients refused to participate. Severity of MG was assessed according to the Osserman and Genkins classification. The participants were evaluated by a sociodemographic form, the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Hamilton Depression Rating Scale 17-item version (HAM-D), and the Hamilton Anxiety Rating Scale (HAM-A).
  
  
  RESULTS
  The patients with stage IIB MG had significantly higher scores on the BAI, HAM-D, HAM-A total and somatic anxiety than those with stage I and IIA MG (p<0.05). Likewise, the patients taking a combination of prednisolone+pyridostigmine/azathioprine had significantly higher scores on the BAI, HAM-D, HAM-A total and somatic anxiety than those taking only prednisolone (p<0.05). Linear regression analysis revealed that disease severity and stressful life events were the factors associated with the HAM-D scores. Disease severity, treatment modalities, and gender were the factors associated with the HAM-A scores.
  
  
  CONCLUSIONS
  The results of the present study may suggest that patients with relatively more severe MG or those taking a combination of immunosupressive and anticholinesterase medications need psychiatric/psychological evaluation.
authors.affiliation: Bakırköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Department of Neurology, İstanbul, Turkey.
authors.forename: Fikret
authors.initials: F
authors.lastname: Aysal
authors.affiliation: Şişli Etfal Teaching and Research Hospital, Department of Psychiatry, İstanbul, Turkey.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Karamustafalioğlu
authors.affiliation: Şişli Etfal Teaching and Research Hospital, Department of Psychiatry, İstanbul, Turkey.
authors.forename: Başak
authors.initials: B
authors.lastname: Özçelik
authors.affiliation: Bakırköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Department of Psychiatry, İstanbul, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Bakırköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Department of Psychiatry, İstanbul, Turkey.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Karamustafalioğlu
authors.affiliation: Şişli Etfal Teaching and Research Hospital, Department of Psychiatry, İstanbul, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Yumrukçal
authors.affiliation: Mental Health and Disease Hospital, Psikiaytr Clinic, Samsun, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Tankaya
keywords: Depression; anxiety; myasthenia gravis; stressful life events