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Modifiable factors associated with depression and anxiety in multiple sclerosis
Author(s) -
Gascoyne Claudia R.,
Simpson Steve,
Chen Jing,
Mei Ingrid,
Marck Claudia H.
Publication year - 2019
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13132
Subject(s) - depression (economics) , medicine , anxiety , confounding , mood , hospital anxiety and depression scale , psychiatry , physical therapy , economics , macroeconomics
Objectives Modifiable lifestyle factors are implicated in multiple sclerosis (MS) symptoms but their role in mood is unclear. This study aimed to investigate associations between lifestyle and depression and anxiety in Australian participants with MS. Materials and Methods Self‐reported data from the Australian Multiple Sclerosis Longitudinal Study included the Hospital Anxiety and Depression Scale (HADS) and lifestyle measurements from 1500 participants. SNAP score (range 0‐5) was the sum of non‐smoking, sufficient fruit/vegetable intake, non‐hazardous alcohol consumption, sufficient physical activity and healthy BMI. Analyses by log‐binomial and linear regression were adjusted for confounding. Results Symptoms of depression and anxiety were prevalent in 27% and 40%, respectively; 20% had both. Mean SNAP score was 2.7/5; only 3% met all healthy lifestyle recommendations. Only 10% reported adequate fruit/vegetable intake, and 22% reported a combination of unhealthy BMI, inadequate physical activity and inadequate nutrition. A healthier SNAP score was associated with lower depression prevalence (adjusted prevalence ratio 0.83 [95% CI 0.75, 0.92] per unit increase) and depression severity (adjusted β‐0.44 [95% CI −0.64, −0.24]), but not with anxiety. Conclusions Modifiable lifestyle factors are associated with lower frequency and severity of depression, but not anxiety, in Australian people with multiple sclerosis. The associations between a healthier SNAP score and lower depression are likely bi‐directional. SNAP risk factor prevalence and co‐occurrence, especially inadequate nutrition and low physical activity, were high among Australians with MS.