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

Abstract：

OBJECTIVE:This study was designed to determine whether pseudoexacerbations and confirmed MS exacerbations are preceded by or concurrent with increased anxiety or depressive symptoms. METHODS: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. RESULTS:Both pseudoexacerbations and confirmed exacerbations were associated with concurrent somatic depressive (β = .16 and β = .33, respectively; p values < .05), affective depressive (β = .17 [p = .02] and β = .12 [p = .06]), and anxiety symptoms (β = .24 and β = .20, p values < .01), controlling for baseline symptoms. Preexisting somatic and affective depressive symptoms predicted amplified relationships between concurrent confirmed exacerbations and these symptoms (β = .19 and β = .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). CONCLUSIONS: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. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT00147446.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

Burns MN,Nawacki E,Siddique J,Pelletier D,Mohr DC

doi

10.1097/PSY.0b013e3182757b2b

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

76-82

issue

eissn

0033-3174

issn

1534-7796

pii

PSY.0b013e3182757b2b

journal_volume

pub_type

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