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Prediction of anxiety and distress following diagnosis of multiple sclerosis: a two-year longitudinal study

Department of Public Health, PO Box 2040, 3000 CA, Department of Neurology, Department of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands, a.janssens{at}erasmusmc.nl

D Buljevac

Department of Neurology, Erasmus MC, Rotterdam, the Netherlands

P A van Doorn

Department of Neurology, Erasmus MC, Rotterdam, the Netherlands

F GA van der Meché

Department of Neurology, Erasmus MC, Rotterdam, the Netherlands

C H Polman

Department of Neurology, VU Medical Center, Amsterdam, the Netherlands

J Passchier

Department of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands

R Q Hintzen

Department of Neurology, Erasmus MC, Rotterdam, the Netherlands

Objective: To investigate the course of anxiety, depression and disease-related distress of patients with multiple sclerosis (MS) and their partners in the first years after diagnosis.

Methods: The Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) were completed at baseline, six-month, one-and two-year follow-up in 101 recently diagnosed patients and 78 partners. The Expanded Disability Status Scale (EDSS) was assessed annually.

Results: Mean time since diagnosis at baseline was 7.8 (SD 6.5) months. Mean anxiety scores of patients and partners did not change during the two years of follow-up and remained higher than that observed in the general population at all assessments (P <0.05). The high levels of disease-related distress at baseline were lower at follow-up. Of the patients and partners with high anxiety scores at baseline (HADS anxiety 8), 69% also had high scores at any time during follow-up, compared to 26% in those with low baseline anxiety scores. For severe distress at follow-up, these percentages were 41 and 14%. The sensitivity and specificity of baseline anxiety screening for the prediction of high anxiety or distress scores at follow-up were 55 and 85%.

Conclusion: MS patients and their partners continued to have high levels of anxiety and distress in the first years after diagnosis. Screening for anxiety after diagnosis can be used to predict levels of anxiety and distress during two-year follow-up.

Key Words: anxiety • depression • diagnosis • distress • multiple sclerosis • prediction

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