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Prospective examination of anxiety and depression before and during confirmed and pseudoexacerbations in patients with multiple sclerosis.


ABSTRACT: This study was designed to determine whether pseudoexacerbations and confirmed MS exacerbations are preceded by or concurrent with increased anxiety or depressive symptoms.This was a secondary analysis of 121 patients with MS who were observed for 48 weeks during a randomized controlled trial. Participants completed monthly self-reports on depressive and anxiety symptoms. Patient-reported exacerbations were assessed through a telephone-administered symptom checklist and neurologic examination.Both pseudoexacerbations and confirmed exacerbations were associated with concurrent somatic depressive (? = .16 and ? = .33, respectively; p values < .05), affective depressive (? = .17 [p = .02] and ? = .12 [p = .06]), and anxiety symptoms (? = .24 and ? = .20, p values < .01), controlling for baseline symptoms. Preexisting somatic and affective depressive symptoms predicted amplified relationships between concurrent confirmed exacerbations and these symptoms (? = .19 and ? = .20, respectively; p values < .01). A standard deviation increase in anxiety symptoms relative to baseline predicted subsequent onset of pseudoexacerbations (odds ratio = 1.54, p = .02), whereas increased somatic depressive symptoms predicted confirmed exacerbations (odds ratio = 1.59, p = .01).Patients with MS experiencing pseudoexacerbations or confirmed exacerbations should be assessed and monitored for depressive and anxiety symptoms, and confirmed exacerbations are particularly concerning in patients with a history of depression. The psychological or psychiatric antecedents of MS exacerbations generate new hypotheses on etiologies of confirmed exacerbations and pseudoexacerbations.clinicaltrials.gov Identifier: NCT00147446.

SUBMITTER: Burns MN 

PROVIDER: S-EPMC3538885 | BioStudies | 2013-01-01

REPOSITORIES: biostudies

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