Association of depression in multiple sclerosis with fatigue, sleep disturbances, disability, and health-related quality of life: Outcomes of a cross-sectional study

Abstract

Introduction

Depression affect individuals with multiple sclerosis (MS) more frequently compared with the general population. It can worsen the symptoms of MS, influence disability progression, and significantly reduce the quality of life (QoL).

Method

We investigated the prevalence of depressive symptoms in a cohort of 200 patients with MS (76% women) and their association with sleep patterns, fatigue, QoL, demographics, and other clinical characteristics in real-world settings. The study was conducted through clinical evaluations and questionnaires related to depression: Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS); fatigue: Modified Fatigue Impact Scale; sleep quality: Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale; and QoL: Multiple Sclerosis Quality of Life-54 (MSQOL-54).

Results

According to the BDI and HDRS, the prevalence of depressive symptoms was 40.5 and 28.27%, respectively. Patients with depressive symptoms exhibited higher disability scores, longer ambulation times, worse cognitive function in the Symbol Digit Modalities Test, and poorer sleep quality. They also had significantly higher fatigue and daytime somnolence scores, as well as lower scores on the MSQOL-54: physical (40.55 vs. 62.3; P < .001) and mental (44.49 vs. 71.89; P < .001) health composites. We demonstrated the correlation between depression and fatigue, as well as their negative impact on QoL in patients with MS.

Conclusion

This study underscores the prevalence and impact of depression in MS, emphasizing the importance of routine screening and active management of psychiatric comorbidities in individuals with MS. These findings contribute valuable insights into the complex interplay between mental health, disease variables, and QoL in MS.