SEATTLE — Multiple sclerosis patients in general appear to have higher rates of anxiety than the general population, but it remains unclear how much their disease course affects that response.
“There are experiences unique to each disease course that might increase the likelihood of anxiety,” wrote researchers from the VA Puget Sound Health Care System and the University of Washington School of Medicine and colleagues. “Additionally, the majority of research in MS has focused on people with relapsing-remitting MS (RRMS), while the experiences of people with progressive forms of MS are understudied.”
To remedy that, the study team focused on anxiety in patients with progressive MS (PMS) and assessed group differences in anxiety compared to RRMS patients. Also taken into account were the unique and common correlates of anxiety in patients with both PMS and RRMS.
The authors conducted a secondary analysis of data from the fourth survey in a longitudinal study of quality of life in people with physical disabilities. Their study included a subset of participants with MS; results were published in Multiple Sclerosis and Related Disorders.1
Researchers measured anxiety level by the 4-item Patient-Reported Outcomes Measurement Information System—Anxiety Short Form T-score. Participants were 464 adults with MS—183 with PMS and 281 with RRMS. The patients were predominately female, non-Hispanic white, and not employed with a mean age of 56.9 ± 10.3 years and disease duration of 17.5 ± 9.3 years.
“On average, participants with PMS reported anxiety symptoms (50.6 ± 8.6) that were comparable to those in the United States general population and statistically lower than participants with RRMS (52.8 ± 9.5; p = 0.01),” the authors explained. “Across MS courses, common factors associated with greater anxiety symptoms were shorter disease duration, lower household income, greater speech and/or swallowing problems and current smoking (tobacco), adjusted R2 = 0.19, F(4, 391) = 22.68, p < 0.001. There was no evidence of unique correlates of anxiety symptoms in participants with either MS course.”
The finding that MS patients, regardless of disease course, reported similar levels of anxiety to the United States general population is inconsistent with earlier studies mostly involving clinical samples, according to the report. Researchers said that suggests a need for further research with community samples of individuals with MS. “This discrepancy may also be due to measurement differences between studies (e.g., screen versus symptom measures),” the authors added.
While participants with RRMS reported greater average anxiety compared to those with PMS, according to the researchers, “the statistically significant difference was small and not clinically significant, indicating the need for further examination and replication. Overall, the findings highlight the wide heterogeneity of anxiety presentation within people with MS and identify potential factors to improve conceptualization and treatment of anxiety in this population. Further research is needed with community and clinical samples to understand anxiety in MS as well as risk and protective factors to improve conceptualization and treatment of anxiety in this population.”
- Knowles LM, Tingey JL, Newman AK, von Geldern G, Alschuler KN. A comparison of anxiety symptoms and correlates of anxiety in people with progressive and relapsing-remitting multiple sclerosis. Mult Scler Relat Disord. 2022 May 28;63:103918. doi: 10.1016/j.msard.2022.103918. Epub ahead of print. PMID: 35700673.
