Anxiety in multiple sclerosis: prevalence and associated factors in a large community sample.

TitleAnxiety in multiple sclerosis: prevalence and associated factors in a large community sample.
Publication TypeJournal Article
AuthorsBamer AM, Amtmann D, Ehde DM, Johnson KL
JournalMultiple Sclerosis

Background: Mood disorders are prevalent in individuals with multiple sclerosis (MS), though unlike depression, little is known about anxiety disorders in this population. To date, no largescale population-based studies have examined the prevalence of anxiety disorders in MS, though small studies estimate the prevalence could be as high as 41%. Objective: To determine the prevalence of anxiety disorder and the association with other demographic and health characteristics, including depressive symptoms, in a large community sample of individuals with MS. Methods: Information on anxiety, depression, demographics, and other health characteristics was collected through a self-report cross-sectional survey of 1,271 individuals with MS in Washington State. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS) and depression using the Patient Health Questionnaire (PHQ-9). Multiple logistic regression using a cut-off of 9 or greater on the HADS was completed to examine factors associated with significant anxiety. Results: 25% of individuals (n=313) met criteria for likely anxiety disorder. Of those, 75% also met criteria for likely depressive disorder on the PHQ-9. Regression results suggest anxiety is associated with difficulties in thinking, higher depressive symptoms, more pain, increased stress, more sleep problems, not using a wheelchair, and with better health on the SF8 physical subscale. Conclusions: Anxiety disorders affect a large percentage of individuals with MS and co-occur with depressive symptoms in 75% of patients. Given the high prevalence and association with other mood and disease symptoms, clinicians should screen for anxiety disorders in individuals with MS and provide treatment when possible to reduce overall disability in this population.

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