MS Patients With Anxiety, Depression Symptoms More Likely to Report Need for Mental Healthcare, Study Shows

One-third of multiple sclerosis (MS) patients in a Canadian study report a need for mental healthcare, with symptoms of anxiety and depression — but not current diagnosed mental health disorders — identified as predominant factors.

The study, “Factors associated with perceived need for mental health care in multiple sclerosis,” was published in the journal Multiple Sclerosis and Related Disorders.

MS patients tend to have several comorbidities — the simultaneous presence of two or more chronic conditions — with depression and anxiety among the most common.

While estimates vary, studies have reported that the rate of depression in MS patients can be as high as 50% and anxiety as high as 35%. The presence of these two comorbidities is associated with worse long-term outcomes, such as a lower quality of life and progression of disability.

Many people may not meet the criteria for a formal diagnosis of either depression or anxiety, but they might still perceive a need for mental healthcare.

Not much is known about the rate of perceived need for mental health care in MS patients. However, this is important given the high prevalence of depression and anxiety in MS and the associated effects on outcomes.

Canadian researchers recruited 255 participants with neurologist-confirmed diagnoses of MS (mainly relapsing-remitting MS), who were part of a larger study assessing psychiatric comorbidities in patients with chronic immune-inflammatory diseases, from a specialized MS care clinic.

Participants underwent cognitive and physical assessments, completed self-administered questionnaires, and were evaluated for psychiatric status.

They were also told to complete a hospital anxiety and depression scale to assess severity of depression and anxiety symptoms, and reported whether they perceived a need for mental health care.

Almost one-quarter of participants (22.7%) had a current diagnosis of depression or anxiety. However, 31.8% reported a need for mental health care, highlighting the discrepancy between diagnosis and the perceived need for care.

Patients who identified a need for mental healthcare were slightly younger and had an earlier age of MS symptom onset than those who did not report a need. However, all other sociodemographic characteristics were similar.

Statistical analysis showed that the likelihood of reporting a need for mental healthcare was 2.36 times higher in those with increased symptoms of depression and 6.08 times higher in those with more anxiety symptoms.

“Symptoms of anxiety and depression, but not current diagnosed mental health disorders, were the predominant factors associated with a perceived need for [mental health] care,” the researchers wrote.

The high perceived need for mental healthcare, even among patients who were currently being treated, suggests that treatment may be inadequate in some way, and that these patients might need more support, family interventions, or other care.

“This need for treatment identified by individuals with elevated symptoms, in the absence of meeting formal criteria for a diagnosis of a psychiatric disorder, suggests that such symptoms are clinically relevant,” the authors said.

They believe that “incorporating validated screening tools for these symptoms into practice along with a question regarding need for mental health care may assist health care providers in better meeting the mental health needs of people with MS.”