Associations of demographic and clinical factors with depression over 2.5-years in an international prospective cohort of people living with MS

https://doi.org/10.1016/j.msard.2019.02.014Get rights and content
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Highlights

  • Depression at follow-up was significantly reduced from baseline (14.5% vs 19.1%).

  • Disability and fatigue had strongest associations with depression risk.

  • Marital status, SES, antidepressants, fatigue independently drive depression gain.

  • MS type, relapse rate, DMDs not independently associated with depression.

Abstract

Background

Depression is highly prevalent among people with MS, and determinants thereof would be useful.

Objectives

We examined the relationship of demographic and clinical factors with positive depression-screen and change in depression over 2.5 years in people with MS.

Methods

Positive depression-screen assessed by Patient Health Questionnaire (PHQ)-2 and PHQ-9. Associations of demographic and clinical factors with depression-screen and change thereof assessed using multivariable regression models, adjusted for age, sex, disability, fatigue, antidepressant use, and baseline PHQ-2, as appropriate.

Results

Overweight/obese BMI, comorbidity number, fatigue, and disability were associated with positive depression-screen, while married/partnered state, being employed, higher perceived socioeconomic status, and greater education were inversely associated with depression-screen. After adjustment, only marital status, socioeconomic status, antidepressant medication use, and fatigue were associated with risk of newly positive depression-screen. MS type, relapse number and immunomodulatory medication use were not associated with depression-screen after controlling for disability and fatigue.

Conclusion

In a large prospective cohort study of depression in people with MS, we substantiated several potential determinants of a positive depression-screen and depression trajectory, particularly fatigue. Given that fatigue is the most common and most significant clinical symptom for people with MS, efforts to reduce fatigue may have follow-on benefits for reducing depression.

Keywords

Multiple sclerosis
Depression
Clinical
Demographic
Epidemiology

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