Prevalence of depression and anxiety among the patients with multiple sclerosis and neuromyelitis optica spectrum disorder at King Chulalongkorn Memorial Hospital
Keywords:
Demyelinating disease, depression, anxietyAbstract
Background: Demyelinating disease is an inflammatory disease of the white matter in the brain and of the sheath that covers the nerves, optic nerves, and spinal cord, and its progression is often found to be continuously recurring and eventually develops into disability, stress, depression and anxiety.
Objectives: To study the prevalence and the related factors of depression and anxiety among patients with demyelinating disease.
Methods: Data were collected from a group of patients diagnosed with demyelinating disease by neurologists at the Outpatient Department, Neurology Unit, King Chulalongkorn Memorial Hospital. Depression and anxiety were assessed with the Thai Hospital Anxiety and Depression Scale (HADS). Social support, family relationships and duties, and the quality of life were assessed as independent variables. The data were analyzed for the prevalence of depression and anxiety. The univariate analysis and binary logistic regression were performed to define the related factors for depression and anxiety.
Results: A total of 82 patients were consecutively recruited, 92.7% were female, and 29.3% had depression or anxiety. Social support level, family relationships and duties, and quality of life were found to be in the moderate level. The multivariate analysis revealed that the factors related to depression or anxiety were the low to medium level of quality of life (ORadj. 9.17 [95% CI 2.23, 37.73]), and personal income below than 31,889 baht per month (ORadj. 4.74 [95% CI 1.24, 18.13]).
Conclusion: Almost one-third of subjects who were diagnosed with demyelinating disease suffered from either depression or anxiety. The related factors were the low quality of life and low income. Therefore, screening for depression and anxiety should be included as part of the caring process in order to increase the treatment effectiveness and quality of life for the patients.
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References
Jitpraphaikulsarn J, Prayoonwiwat N. Demyelinating Disease of the Central Nervous System, NMO type. Part 1 (Neuromyelitis optica). [Internet]. 2020 [cited 2020 Oct 28]. Available from: https://www.si.mahidol. ac.th/sidoctor/e-pl/articledetail.asp?id=1235
Apiwattanakul M. Clinical practice guidelines: Multiple sclerosis and neoromyelitis optica spectrum disorder. Bangkok: Tanapress; 2018.
Prayoonwiwat N, Pasokpadde P, Apiwatanakul M, Siritho S, Chanatittarat C, Chaikledkaew U. Prevalence of idiopathic inflammatory demyelinating central nervous system disorder in Thailand. Pan Asian Pharmaceutical Sciences Asia 269 Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS); 2013; Taiwan.
Department of Mental Health. Ministry of Public Health. MS Disease, The disease in which: the working age should be aware of Department of Mental Health. [Internet]. 2015 [cited 2018 Dec 20]. Available from: https://www.dmh.go.th/news-dmh/view.asp?id=25729
Shi Z, Chen H, Lian Z, Liu J, Feng H, Zhou H. Factors that impact health-related quality of life in neuromyelitis optica spectrum disorder: anxiety, disability, fatigue and depression. J Neuroimmunol 2016;293:54-8. https://doi.org/10.1016/j.jneuroim.2016.02.011
Siengsukon CF, Alshehri M, Aldughmi M. Self-report sleep quality combined with sleep time variability distinguishes differences in fatigue, anxiety, and depression in individuals with multiple sclerosis: A secondary analysis. Mult Scler J Exp Transl Clin 2018;4:doi:10.1177/2055217318815924.
https://doi.org/10.1177/2055217318815924
Brenner P, Alexanderson K, Björkenstam C, Hillert J, Jokinen J, Mittendorfer-Rutz E, et al. Psychiatric diagnoses, medication and risk for disability pension in multiple sclerosis patients; a population-based register study. PLoS One 2014;9:e104165. https://doi.org/10.1371/journal.pone.0104165
Miao XH, Shi ZY, Chen HX, Zhou HY, Yang R. Anxiety and depression in patients with neuromyelitis optica. Sichuan Da Xue Xue Bao Yi Xue Ban 2017;48:900-4.
Tsivgoulis G, Triantafyllou N, Papageorgiou C, Evangelopoulos ME, Kararizou E, Sfagos C, et al. Associations of the expanded disability status scale with anxiety and depression in multiple sclerosis outpatients. Acta Neurol Scand 2007;115:67-72. https://doi.org/10.1111/j.1600-0404.2006.00736.x
Seok JM, Cho EB, Lee HL, Cho HJ, Min JH, Lee KH, et al. Clinical characteristics of disabling attacks at onset in patients with neuromyelitis optica spectrum disorder. J Neurol Sci 2016;368:209-13.
https://doi.org/10.1016/j.jns.2016.06.030
Alba Palé L, León Caballero J, Samsó Buxareu B, Salgado Serrano P, Pérez Solà V. Systematic review of depression in patients with multiple sclerosis and its relationship to interferon treatment. Mult Scler Relat Disord 2017;17:138-43. https://doi.org/10.1016/j.msard.2017.07.008
Jitpraphaikulsarn J, Prayoonwiwat N. What Should I Do, When I am diagnosed with NMO. [Internet]. 2020 [cited 2020 Oct 28.]. Available from: https://www.si.mahidol.ac.th/siriraj_online/thai_version/Health_detail.asp?id=1282
Panda SP, Das RC, Srivastava K, Ratnam A, Sharma N. Psychiatric comorbidity in multiple sclerosis. Neurol Neurochir Pol 2018;52:704-9. https://doi.org/10.1016/j.pjnns.2018.09.003
Marrie RA, Patten SB, Berrigan LI, Tremlett H, Wolfson C, Warren S, et al. Diagnoses of depression and anxiety versus current symptoms and quality of life in multiple sclerosis. Int J MS Care 2018;20:76-84.
https://doi.org/10.7224/1537-2073.2016-110
Chanson JB, Zéphir H, Collongues N, Outteryck O, Blanc F, Fleury M, et al. Evaluation of health-related quality of life, fatigue and depression in neuromyelitis optica. Eur J Neurol 2011;18:836-41.
https://doi.org/10.1111/j.1468-1331.2010.03252.x
Boeschoten RE, Braamse AMJ, Beekman ATF, Cuijpers P, van Oppen P, Dekker J, et al. Prevalence of depression and anxiety in multiple sclerosis: A systematic review and meta-analysis. J Neurol Sci 2017;372:331-41. https://doi.org/10.1016/j.jns.2016.11.067
Charoensak S, Samajarn S, Siritho S, Prayoonwiwat N. Prevalence of psychiatric disorders in patients with demyelinating disease in MS clinic Siriraj Hospital. J Psychiatr Assoc Thai 2012;57:175-84.
Patten SB, Marrie RA, Carta MG. Depression in multiple sclerosis. Int Rev Psychiatry 2017;29:463-72.
https://doi.org/10.1080/09540261.2017.1322555
Daniel WW, Cross CL. Biostatistics: A foundation for analysis in the health sciences, 10th ed. New York: John Wiley & Sons Inc.;1995. p. 180.
Nilchaikovit T, Lortrakul M, Phisansuthideth U. Development of Thai version of hospital anxiety and depression scale in cancer patients. J Psychiatr Assoc Thai 1996;41:18-30.
Watson TM, Ford E, Worthington E, Lincoln NB. Validation of mood measures for people with multiple sclerosis. Int J MS Care 2014;16:105-9. https://doi.org/10.7224/1537-2073.2013-013
Lueboonthavatchai P, Lueboonthavatchai O. Quality of life and correlated health status and social support of schizophrenic patients' caregivers. J Med Assoc Thai 2006;89 Suppl 3: 13-9.
Lueboonthavatchai P. Prevalence and psychosocial factors of anxiety and depression in breast cancer patients. J Med Assoc Thai 2007;90:2164-74.
Mahatnirunkun S, Tantipiwattanasakun W, Pumphaisarnchai W, Wongsuwan K, Pornmanajirangkul R. Comparison of the World Health Organization Quality of life indicator for every 100 and 26 indicators Chiang Mai: Suan Prung Hospital, 1998.
Shin JS, Kwon YN, Choi Y, Lee JY, Lee YI, Hyun J, et al. Comparison of psychiatric disturbances in patients with multiple sclerosis and neuromyelitis optica. Medicine (Baltimore) 2019;98:doi:10.1097/MD. 0000000000017184.https://doi.org/10.1097/MD.0000000000017184
Weich S, Lewis G, and Jenkins SP. Income inequality and the prevalence of common mental disorders in Britain. Br J Psychiatry 2001;178:222-7. https://doi.org/10.1192/bjp.178.3.222
Wongpoom T, Sukying C, Udomsubpayakul U. Prevalence of depression among the elderly in Chiang Mai province. J Psychiatr Assoc Thai 2011;56:103-16.
Caron J, Liu A. A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations. Chronic Dis Can 2010;30:84-94. https://doi.org/10.24095/hpcdp.30.3.03
Yaiyong O, Lueboonthavatchai P. Depression and grief of the elderly at the elderly associate in Nonthaburi Province. J Psychiatr Assoc Thai 2011;56:117-28.
Markowitz JC, Klerman GL, Weissman M. Comprehensive guide to interpersonal psychotherapy. New York: Basic Books; 2000.
Jitaree B. The factors influencing depression among the elderly at a community in Nakhon Pathom Province. [dissertation]. Nakhon Pathom: Christian University of Thailand; 2012.
Prisnie JC, Sajobi TT, Wang M, Patten SB, Fiest KM, Bulloch AGM, et al. Effects of depression and anxiety on quality of life in five common neurological disorders. Gen Hosp Psychiatry 2018;52:58-63.
https://doi.org/10.1016/j.genhosppsych.2018.03.009
Hellmann-Regen J, Piber D, Hinkelmann K, Gold SM, Heesen C, Spitzer C, et al. Depressive syndromes in neurological disorders. Eur Arch Psychiatry Clin Neurosci 2013; 263 Suppl 2:S123-36.
https://doi.org/10.1007/s00406-013-0448-6
Jaracz K, Pawlak M, Górna K, Kołcz B, Wołoszyn D, Kozubski W. Quality of life and social support in patients with multiple sclerosis. Neurol Neurochir Pol 2010;44:358-65.
https://doi.org/10.1016/S0028-3843(14)60295-4
Janardhan V, Bakshi R. Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. J Neurol Sci 2002;205:51-8. https://doi.org/10.1016/S0022-510X(02)00312-X
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