Research: depression and relapses

Moore et al. Multiple sclerosis relapses and depression. J Psychosom Res. 2012;73:272-6

OBJECTIVE: The expression of clinically significant depression symptoms during and post MS relapse was investigated. The point prevalence of possible depression during a confirmed MS relapse and at 2 and 6 months post-relapse was examined and the influence of disability on the time course of depression symptoms post-relapse determined.
METHODS: 132 sequential MSers were recruited from an open access relapse clinic. Clinical data including disability (Expanded Disability Status Scale: EDSS) and depression symptoms (Hospital Anxiety and Depression Scale depression subscale: HADS-D) were recorded at 0, 2 and 6 months post-relapse.

RESULTS: Prevalence of possible depression (HADS-D score of≥8) was 44.5% during relapse, reducing to 29.2% at 2 months and 34.4% at 6 months post-relapse. HADS-D scores were significantly lower at follow-up than during relapse. Possible depression at relapse was significantly related to a higher likelihood of possible depression at 2 month follow-up (OR 12.12) and improvement in EDSS was related to a lower likelihood (OR 0.51). EDSS at relapse (OR 1.47) and possible depression at relapse (OR 11.87) were significantly associated with possible depression 6 months post-relapse.

CONCLUSIONS: High rates of possible depression were observed during relapse. Although depression scores reduced significantly post-relapse, rates of possible depression at follow-ups remained high. The results suggest that although improvements in disability may influence depression symptoms over the short-term, once depression symptoms are elevated at relapse then depression symptoms become persistent.
 

"Not surprising that there is a link between clinical disease activity and depression. What is not clear is the mechanism. Does it relate to lesions in parts of the brain associated with cognitive problems? Do the inflammatory mediators released during a relapse cause depression? Is it a reactive depression in response to  having a relapse? Clinical attacks are a reminder that you have a disease and bring back anxiety about the future, both near and far. Will I recover from this attack? Will I need a walking aid? What will happen to my job? Will I be able to complete University? How will I pay for my daughter's wedding? What is happening to me? Etc.? Etc.? This is another good reason to prevent relapses; why should MSers have relapses if we can prevent them and possibly the associated depression that goes with  them? Any thoughts on this?"

Other posts of interest in relation to depression:

01 Sep 2012
Very interesting - I have suffered from depression for a very long time and always have felt that it must be 'organic' i.e. related to some brain changes. It would be interesting to know if depression in female MSers is among the ...
12 Aug 2012
INTRODUCTION: Studies have found that people with Multiple Sclerosis experience relatively high rates of anxiety and depression. Although methodologically robust, many of these studies had access to only modest sample ...
21 Jul 2012
Methods: In this cross-sectional study, the authors evaluated 49 children with demyelinating disorders (multiple sclerosis and acute disseminated encephalomyelitis) and 92 healthy controls for depression and/or fatigue using ...
27 Jun 2012
The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety (cut-point >7) and depression (>7) and the Fatigue Severity Scale (FSS) to measure fatigue (≥5). Results: At cohort entry, prevalence of ...

22 Nov 2011
Results: MS'ers with depression had a 10 point lower MPR (P < 0.01) and were less likely to achieve a MPR of at least 80% (odds ratio (OR) = 0.55; 95% confidence interval (CI) 0.42-0.74) than those without depression.
19 Aug 2011
Fatigue and its relationships with cognitive functioning and depression in paediatric multiple sclerosis. Mult Scler. 2011 Aug 15. Background: There is limited information on fatigue and its clinical and psychosocial correlates in ...
12 May 2011
There is a high prevalence of depression in PwMS and other neurological disorders. A systematic review and meta-analysis of 20 randomised controlled trials showed that anti-depressant treatment was associated with a ...
18 Jun 2012
69 couples completed measures of mindfulness, acceptance and adjustment (depression, anxiety, life satisfaction, positive affect and relationship satisfaction). Results: As hypothesised there were actor effects of mindfulness ...

17 Dec 2011
BACKGROUND: MS'ers are at high risk of depression. This pilot study of computerised cognitive behavioural therapy (CCBT) for the treatment of depression in MS'ers was to test the feasibility of undertaking a full trial.

20 Jan 2011
Cognitive symptoms and depression are common in people with MS. A recent study shows an association between these symptoms; subjects with cognitive impairment were more likely to report low mood. Barwick FH, Arnett ...


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