CONNECTION BETWEEN COMORBID PRIMARY HEADACHE, DEPRESSION AND ANXIETY IN PATIENTS WITH MULTIPLE SCLEROSIS
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14175Keywords:
multiple sclerosis, headache, comorbidity, anxiety, depression, pain syndromeAbstract
SUMMARY. Multiple sclerosis (MS) is a chronic autoimmune disorder of central nervous system that affects young people and progresses to physical disability. Among patient with MS risk of excessive anxiety and depression is quite common. One of the frequent comorbidities of MS is primary comorbid headache. Depression and anxiety might be more prominent on patients with pain comorbidity of MS.
The aim – to show the prevalence and frequency of depression and anxiety in a population of patients with MS, with special attention to the group of patients with primary comorbid headache.
Material and Methods. MS was confirmed according to the McDonald criteria 2017. Questionnaires Beck Depression Inventory (BDI) for assessment of depression and The Spielberger State-Trait Anxiety Inventory in Hanin`s interpretation (STAI), version for evaluation of reactive anxiety were used.
Results. 130 patients with MS were examined with disease duration 8.63±7.49 years. 36.2 % of males (n=47) and 63.8 % of females (n=83) were included. Average score of patients with MS was 40.22±8.89 points that indicates moderate reactive anxiety. BDI score accounted for 14.15±7.58 points that interpretates as mild-to-moderate depression. Patients with MS and comorbid primary headache received the average points of the STAI in Hanin's interpretation – 42.41±7.49 (moderate anxiety); patients with MS without comorbid primary headache – 37.42±9.31 (low or moderate anxiety), but generally this difference did not show statistical significance (p=0.39). Among MS course scores of anxiety was similar between groups, depression score was the highest in group with primary progressive MS (PPMS).
Conclusion. The average score of anxiety and depression showed moderate severity among patients with MS. There were not found significance between patients with primary headache comorbidity and without it, although scores between course disease subgroups showed higher points in patients with comorbid primary headache.
References
Baldt, J., Frahm, N., Hecker, M., Streckenbach, B., Langhorst, S.E., Mashhadiakbar, P,… Richter, J. (2023). Depression and Anxiety in Association with Polypharmacy in Patients with Multiple Sclerosis. Journal of Clinical Medicine, 12(16), 5379. DOI: 10.3390/jcm12165379. DOI: https://doi.org/10.3390/jcm12165379
Andriievska, M.I. (2022). Comorbid primary headache: occurance and prevalence in patients with relapsing remitting multiple sclerosis. Art of Medicine, 23(3), 7-11. DOI: 10.21802/artm.2022.3.23.7. DOI: https://doi.org/10.21802/artm.2022.3.23.7
Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis – a review. European journal of neurology, 26(1), 27-40. DOI: 10.1111/ene.13819. DOI: https://doi.org/10.1111/ene.13819
AlSaeed, S., Aljouee, T., Alkhawajah, N.M., Alarieh, R., AlGarni, H., Aljarallah, S., Ayyash, M., & Abu-Shaheen, A. (2022). Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients. Front. Immunol., 13. DOI: 10.3389/fimmu.2022.844461. DOI: https://doi.org/10.3389/fimmu.2022.844461
Marrie, R.A., & Hanwell, H. (2013). General health issues in multiple sclerosis: Comorbidities, secondary conditions, and health behaviors. Continuum. (Minneap. Minn.), 19, 1046-1057. DOI: 10.1212/01.CON.0000433284.07844.6b. DOI: https://doi.org/10.1212/01.CON.0000433284.07844.6b
Files, D.K., Jausurawong, T., Katrajian, R., & Danoff, R. (2015). Multiple sclerosis. Prim. Care, 42, 159-175. DOI: 10.1016/j.pop.2015.01.007. DOI: https://doi.org/10.1016/j.pop.2015.01.007
Giordano, A., Granella, F., Lugaresi, A., Martinelli, V., Trojano, M., Confalonieri, P., Radice, D., & Solari, A. (2011). Anxiety and depression in multiple sclerosis patients around diagnosis. J. Neurol. Sci., 307, 86-91. DOI: 10.1016/j.jns. 2011.05.008. DOI: https://doi.org/10.1016/j.jns.2011.05.008
Tsivgoulis, G., Triantafyllou, N., Papageorgiou, C., Evangelopoulos, M., Kararizou, E., Sfagos, C., & Vassilopoulos, D. (2007). Associations of the Expanded Disability Status Scale with anxiety and depression in multiple sclerosis outpatients. Acta Neurol. Scand., 115, 67-72. DOI: 10.1111/ j.1600-0404.2006.00736.x. DOI: https://doi.org/10.1111/j.1600-0404.2006.00736.x
Solaro, C., Gamberini, G., & Masuccio, F.G. (2018). Depression in Multiple Sclerosis: Epidemiology, Aetiology, Diagnosis and Treatment. CNS Drugs, 32, 117-133. DOI: 10.1007/s40263-018-0489-5. DOI: https://doi.org/10.1007/s40263-018-0489-5
Ensari, I., Pilutti, L.A., & Motl, R.W. (2017). Depressive symptomology in multiple sclerosis: Disability, cardiorespiratory fitness and heart rate variability. Acta Neurol. Scand., 136, 440-446. DOI: 10.1111/ane.12748. DOI: https://doi.org/10.1111/ane.12748
Batista, A.R., Silva, S., Lencastre, L., & Guerra, M.P. (2022). Biopsychosocial Correlates of Quality of Life in Multiple Sclerosis Patients. Int. J. Environ. Res. Public Health, 19. DOI: 10.3390/ijerph192114431. DOI: https://doi.org/10.3390/ijerph192114431
Łabuz-Roszak, B., Niewiadomska, E., & Kubicka-Bączyk, K. (2019). Prevalence of pain in patients with multiple sclerosis and its association with anxiety, depressive symptoms and quality of life. Psychiatria Polska, 53(2), 475-486. DOI: 10.12740/PP/94469. DOI: https://doi.org/10.12740/PP/94469
Julián, L. (2011). Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care & Research, 63(S11). DOI: 10.1002/acr.20561. DOI: https://doi.org/10.1002/acr.20561
Ilić, P., Motl, R.W., & Duffecy, J. (2023). Multiple sclerosis and anxiety: Is there an untapped opportunity for exercise? Mult. Scler. Relat. Disord., 73. DOI: 10.1016/j.msard.2023.104698. DOI: https://doi.org/10.1016/j.msard.2023.104698
McIntosh, G.E., Liu, E.S., Allan, M., & Grech, L.B. (2023). Clinical Practice Guidelines for the Detection and Treatment of Depression in Multiple Sclerosis: A Systematic Review. Neurol. Clin. Pract., 13. DOI: 10.1212/CPJ. 0000000000200154. DOI: https://doi.org/10.1212/CPJ.0000000000200154
Janssens, A.C.J.W., van Doorn, P.A., de Boer, J.B., van der Meché, F.G.A., Passchier, J., & Hintzen, R.Q. (2003). Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurol. Scand., 108, 389–395. DOI: 10.1034/ j.1600-0404.2003.00166.x. DOI: https://doi.org/10.1034/j.1600-0404.2003.00166.x
Peres, D.S., Rodrigues, P., Viero, F.T., Frare, J.M., Kudsi, S.Q., Meira, G.M., & Trevisan, G. (2022). Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: A systematic review and meta-analysis. Brain, Behav. Immun. Health, 24. DOI: 10.1016/j.bbih.2022.100484. DOI: https://doi.org/10.1016/j.bbih.2022.100484
Ploughman, M., Wallack, E.M., Chatterjee, T., Kirkland, M.C., & Curtis, M.E. (2020). Under-treated depression negatively impacts lifestyle behaviors, participation and health-related quality of life among older people with multiple sclerosis. Mult. Scler. Relat. Disord., 40, 101919. DOI: 10.1016/j.msard.2019.101919 DOI: https://doi.org/10.1016/j.msard.2019.101919
