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Longitudinal assessment of anxiety, depression, and fatigue in people with multiple sclerosis
Author(s) -
Brown R. F.,
Valpiani E. M.,
Tennant C. C.,
Dunn S. M.,
Sharrock M.,
Hodgkinson S.,
Pollard J. D.
Publication year - 2009
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1348/147608308x345614
Subject(s) - anxiety , psychosocial , depression (economics) , stressor , longitudinal study , distress , medicine , coping (psychology) , psychology , clinical psychology , psychiatry , pathology , economics , macroeconomics
Objectives. No longitudinal studies have concurrently evaluated predictors of anxiety, depression, and fatigue in people with multiple sclerosis (PwMS). This study determined factors that best predicted anxiety, depression, and fatigue in MS patients from a large pool of disease, cognitive, life‐event stressor (LES), psychosocial, life‐style, and demographic factors. Design. A 2‐year prospective longitudinal study evaluated predictors of psychological distress and fatigue in PwMS. Methods. One hundred and one consecutive participants with MS were recruited from two MS clinics in Sydney, Australia. LES, anxiety, depression, and fatigue were assessed at baseline and at 3‐monthly intervals for 2‐years. Disease, cognitive, demographic, psychosocial, and life‐style factors were assessed at baseline. Patient‐reported relapses were recorded and corroborated by neurologists or evaluated against accepted relapse criteria. Results. Depression strongly predicted anxiety and fatigue, and anxiety and fatigue strongly predicted later depression. Psychological distress (i.e. anxiety, depression) was also predicted by a combination of unhealthy behaviours (e.g. drug use, smoking, no exercise, or relaxation) and psychological factors (e.g. low optimism, avoidance coping), similar to the results of community‐based studies. However, state‐anxiety and fatigue were also predicted by immunotherapy status, and fatigue was also predicted by LES and demographics. Conclusions. These results suggest that similar factors might underpin psychological distress and fatigue in MS patients and community‐well samples, although MS treatment factors may also be important. These results might assist clinicians in determining which MS patients are at greatest risk of developing anxiety, depression, or fatigue.