Anxiety in Patients with Multiple Sclerosis: Association with Disability, Depression, Disease Type and Sex


The aim of the current study was to evaluate anxiety in patients with multiple sclerosis (MS) and factors which are associated with this symptom. Eighty totals of 180 patients with MS were enrolled in this cross-sectional study. They were asked to answer the valid and reliable Persian version of the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) questionnaires. Demographic characteristics (sex and age), duration of the disease, disease course and Kurtzke Expanded Disability Status Scale (EDSS) were recorded for all participants. Mean BDI was 17.5 ± 11.4 in patients while mean BAI was17.7 ± 12.5 in all participants, respectively. Mean BDI and BAI were not statistically different between male and female participants. Patients with higher levels of disability (higher EDSS) had significant higher BDI and BAI scores and there was significant positive correlation between EDSS and BDI and BAI scores (rho=0.42, P<0.001, rho=0.35, P<0.001). Patients with SP (Secondary progressive) type of disease had significant higher BDI and BAI score. Multiple linear regression analysis showed that depression and disability level were independent predictors of anxiety in patients. Anxiety and factors which are related with this symptom should be considered in MS patients.

Ghajarzadeh M, Jalilian R, Eskandari G, et al. Validity and reliability of Persian version of Modified Fatigue Impact Scale (MFIS) questionnaire in Iranian patients with multiple sclerosis. Disabil Rehabil 2013;35(18):1509-12.

Randolph JJ, Arnett PA. Depression and fatigue in relapsing_/remitting MS: the role of symptomatic variability. Mult Scler 2005;11(2):186-90.

Ziemssen T. Multiple sclerosis beyond EDSS: depression and fatigue. J Neurol Sci 2009;277(Suppl 1):S27-41.

Minden SL, Schiffer RB. Affective disorders in multiple sclerosis.Review andrecommendations for clinical research. Arch Neurol1990;47(1):98-104

Feinstein A. The neuropsychiatry of multiple sclerosis. Can J Psychiatry 2004;49(3):157-63.

Korostil M, Feistein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler 2007;13(1):67-72.

Janssens AC, van Doorn PA, de Boer JB, et al. Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurol Scand 2003;108(6):389-95.

Garfield AC, Lincoln NB. Factors affecting anxiety in multiple sclerosis. Disabil Rehabil 2012;34(24):2047-52.

Ghassemzadeh H, Mojtabai R, Karamghadiri N, et al. Psychometric properties of a Persianlanguage version of the Beck Depression Inventory— Second edition: BDI-IIPERSIAN. Depress Anxiety 2005;21(4):185-92.

Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J 2008;66(2):136-40.

Beiske AG, Svensson E, Sandanger I, et al. Depression and anxiety amongst multiple sclerosis patients. Eur J Neurol 2008;15(3):239-45.

Gottberg K, Einarsson U, Fredrikson S, et al. Apopulation-based study of depressive symptoms in multiple sclerosis in Stockholm County. Association with functioning and sense of coherence. J Neurol Neurosurg Psychiatry 2007;78(1):60-5.

Janssens AC, Buljevac D, van Doorn PA, et al. Prediction of anxiety and distress following diagnosis of multiple sclerosis: a two-year longitudinal study. Mult Scler 2006;12(6):794-801.

Dahl OP, Stordal E, Lydersen S, et al. Anxiety and depression in multiple sclerosis. A comparative population-based study in Nord-Trøndelag County, Norway. Mult Scler 2009;15(12):1495-501.

da Silva AM, Vilhena E, Lopes A, et al. Depression and anxiety in a Portuguese MS population: associations with physical disability and severity of disease. J Neurol Sci 2011;306(1-2):66-70.

Roy-Byrne PP, Stang P, Wittchen HU, et al. Lifetime panic-depression comorbidity in the National Comorbidity Survey. Association with symptoms, impairment, course and helpseeking. Br J Psychiatry 2000;176:229-35.

Feinstein A. An examination of suicidal intent in patients with multiple sclerosis. Neurology 2002;59(5):674-8.

Nortvedt MW, Riise T, Myhr K-M, et al. Quality of life as a predictor for change in disability in MS. Neurology 2000;55(1):51-4.

Mohr DC, Goodkin DE, Islar J, et al. Treatment of depression associated with suppression of non-specific and antigen specific TH1 responses in multiple sclerosis. Arch Neurol 2001;58(7):1081-6.

IssueVol 52, No 12 (2014) QRcode
Anxiety Multiple Sclerosis Depression Disease

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How to Cite
Askari F, Ghajarzadeh M, Mohammadifar M, Azimi A, Sahraian MA, Owji M. Anxiety in Patients with Multiple Sclerosis: Association with Disability, Depression, Disease Type and Sex. Acta Med Iran. 52(12):889-892.