1Sondes Bader, 1Imen Ketata, 1Fatma Sghaier, 1Emna Ellouz
1Neurology Department, Gabes Hospital, Gabes, Tunisia
Depression symptoms and major depression disorderare highly prevalent in multiple sclerosis(MS). Depression can worsen symptoms of MS and significantly reduced the patient’s quality of life and increased the suicidal risk.The aim of our study was to assess depression in multiple sclerosis patients and to explore its associated factors
Material(s) and Method(s):
We conducted a cross-sectional study, carried out on MS patients who consult in the neurology department of Gabes’shospital during a period of five months, from the 1st June 2021 to 25th October 2021.We used a pre-established sheet exploring the socio-demographic, clinical and therapeutic data of the patients.The Beck Depression Inventory (BDI) to measure characteristic attitudes and symptoms of depression The Expanded Disability Status Scale (EDSS) to quantify disability in MS patients.The Symbol Digit Modalities Test (SDMT) to detect cognitive impairment.Data were analyzed using the software SPSS (20th edition).
Nineteen patients were included. Eleven(57,9%) were females, mean age: 31,5 (SD=8,06) years. Fifty tow percent were married.Only two patients(10,5%)had a family history of MS.Four patients(21,1%) had a family psychiatric history.Five patients (26,3%) had a psychiatric history including depression in 10,5% anxiety disorder in 10,5% and psychotic disorder in 5,2% of cases.Two patients(10,5%) with moderate depression according to BDI had a history of suicidal attempt before MS onset. All patient had the remitting form of MS.The prevalence of depression was 89,4% according to BDI withmild depression in 26,3%, moderate depression in 26,3% and severe depression in 36,8%..MedianBDI score was 12,4 (3, 29).This represents moderate depression.Median SDMT score was 29 (18-41)..There was a significant association between depressioncerebellar lesion(p=0,038:Fisher test;OR=14[1,1-185]).Severe depression was more frequently observed in patients with higher EDSS(moderate to significant disability)(71,4% VS 41,7%) also in patient with cognitive impairment (100%VS 91,7%).No differences were observed regarding sex, marital and occupational status, education, family history of psychiatric disorders, disease course,disability according to the EDSS and cognitive impairment according to SDMT.
The results of this study suggest that patients with MS are at risk to develop depression symptoms and that MS patients with severe depression may experience cognitive function impairment and present a high score of disability.Therefore depression should be assessed in MS patients to prevent motor and cognitive worsening.