University Of Tasmania

File(s) under permanent embargo

Anxiety, depression and fatigue at 5-year review following CNS demyelination

journal contribution
posted on 2023-05-18, 19:06 authored by Steve Simpson JRSteve Simpson JR, Tan, H, Petr OtahalPetr Otahal, Bruce TaylorBruce Taylor, Ponsonby, AL, Lucas, RM, Christopher BlizzardChristopher Blizzard, Valery, PC, Lechner-Scott, J, Shaw, C, Williams, D, Ingrid van der MeiIngrid van der Mei
BACKGROUND: Anxiety and depression are common in multiple sclerosis (MS). We evaluated the prevalence and factors associated with anxiety, depression and fatigue at the 5-year review of a longitudinal cohort study following a first clinical diagnosis of CNS demyelination (FCD).

METHODS: Cases with a FCD were recruited soon after diagnosis and followed annually thereafter. A variety of environmental, behavioural and clinical covariates were measured at five-year review. Anxiety and depression were measured using the Hospital Anxiety & Depression Scale (HADS), and fatigue by the Fatigue Severity Scale (FSS).

RESULTS: Of the 236 cases, 40.2% had clinical anxiety (median HADS-A: 6.0), 16.0% had clinical depression (median HADS-D: 3.0), and 41.3% had clinical fatigue (median FSS: 4.56). The co-occurrence of all three symptoms was 3.76 times greater than expectation. Younger age, higher disability, concussion or other disease diagnosis were independently associated with a higher anxiety score; male sex, higher disability, being unemployed, less physical activity, and antidepressant and/or anxiolytic-sedative medication use were independently associated with a higher depression score. Higher disability, immunomodulatory medication use, other disease diagnosis and anxiolytic-sedative medication use were independently associated with having fatigue, while female sex, higher BMI, having had a concussion, being unemployed and higher disability were associated with a higher fatigue score.

CONCLUSION: These results support previous findings of the commonality of anxiety, depression and fatigue in established MS and extend this to post-FCD and early MS cases. The clustering of the three symptoms indicates that they may share common antecedents.


Publication title

Acta Neurologica Scandinavica










Menzies Institute for Medical Research


Wiley-Blackwell Publishing, Inc.

Place of publication

350 Main St, Malden, MA 02148 United States

Rights statement

Copyright 2016 John Wiley & Sons

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

Usage metrics

    University Of Tasmania