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Anxiety as a Predictor of Depression in Multiple Sclerosis

March 21, 2017

Anxiety is a strong predictor of depression in people with multiple sclerosis, according to a study published in BMC Neurology. In addition, it predicts via both direct and indirect pathways.

While there is a high comorbidity of anxiety and depression in people with MS, the association between the two remains ambiguous. Drawing on Watson and Clark's model of anxiety and depression as well as Rachman's proposal of emotional processing, researchers from the psychology department at the University of Paris West in Nanterre, France, set out to clarify both the relationship between anxiety and depression and the relevance of emotional processing, emotional balance, and coping to depression.

“A key issue is how emotional perturbations (imbalances in positive and negative emotions and emotional processing deficits) lead to depression and whether anxiety exerts an impact directly on depression in MS or whether it influences depression via factors related to emotional processing,” lead Marie-Claire Gay, PhD, said.1

Researchers relied on 189 participants (121 women and 68 men; mean age, 47.2), recruited from 3 French hospitals,who were diagnosed with MS to complete a series of questionnaires to test the following areas:

  • anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS)
  • emotional processing, measured by the Emotional Processing Scale (EPS-25)
  • emotional balance, measured by the Positive and Negative Emotionality Scale (EPN-31)
  • alexithymia, measured by Bermond-Vorst Alexithymia Questionnaire (BVAQ)
  • coping, measured by the Coping with Health Injuries and Problems-Neuro (CHIP-Neuro) Questionnaire

Based on the results from these self-reported answers, researchers deemed depression to be prevalent in people with MS and that people with MS had emotional balance perturbations in keeping with the Watson-Clark model.

However, the study also presented distinctions from the Watson-Clark study: people with MS and probably anxiety disorder also demonstrated perturbation of positive emotions, while populations of non-depressed people with MS reported high levels of negative emotions but low levels of positive emotions, suggesting that having negative emotions alone is not enough to warrant a diagnosis of depression. Anxiety and dysfunctional emotional processing strongly suggest the existence of negative emotions in depression.


Via Psychiatry Advisor