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Factors associated with perceived need for mental health care in multiple sclerosis.

Abstract

BACKGROUND

Within the multiple sclerosis (MS) population, depression and anxiety are highly prevalent comorbidities that are associated with adverse outcomes such as diminished quality of life and disability progression. In the general population, many people who do not meet formal diagnostic criteria for depression or anxiety disorders still identify a need for mental health care. Limited data are available regarding the perceived need for mental health care among persons with MS.

OBJECTIVE

We aimed to determine factors associated with a perceived need for mental health care in the MS population.

METHODS

Participants with MS completed the Hospital Anxiety and Depression Scale (HADS) to assess severity of depression and anxiety symptoms, and reported whether they perceived a need for mental health care, in the context of a larger study examining the burden of psychiatric disorders in immune-mediated inflammatory disease. Participants were also evaluated using the Structured Clinical Interview for DSM-IV-TR (SCID) to diagnose depression or anxiety disorders. Participants reported their sociodemographic characteristics, and underwent physical assessments to determine their disability status. Descriptive analyses and binary logistic regression models were used to determine sociodemographic and clinical factors associated with perceived need for mental health care.

RESULTS

Of 255 participants enrolled, 251 were included in this analysis. Most participants were women, Caucasian, with post-secondary education, with a mean (SD) age at enrollment of 50.9 (12.9) years. They predominantly had a relapsing-remitting MS course. Nearly one-quarter of participants had a current SCID diagnosis of depression or anxiety (n = 57, 22.7%). Overall, 31.8% (n = 80) of participants reported a need for mental health care. These individuals were slightly younger at enrollment (p = 0.037), but otherwise did not differ with respect to sociodemographic characteristics, compared to participants not reporting this need. Those identifying need for mental health care also had an earlier age of MS symptom onset (p = 0.011). After adjusting for sociodemographic and clinical factors, elevated symptoms of depression (odds ratio [OR] 2.36; 95%CI: 1.06, 5.25) and anxiety (OR 6.08; 95%CI: 2.78, 13.3) were associated with an increased likelihood of reporting a need for mental health care. Any current SCID diagnosis of depression or anxiety was not associated with perceived need for mental health care after accounting for symptoms of depression and anxiety.

CONCLUSIONS

One-third of people with MS identified a need for mental health care. Symptoms of anxiety and depression, but not current diagnosed mental health disorders, were the predominant factors associated with a perceived need for care.

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  • Authors+Show Affiliations

    ,

    Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

    ,

    Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

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    Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

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    Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.

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    Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

    ,

    Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

    ,

    Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

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    Nova Scotia Health Authority, Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada.

    ,

    Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: rmarrie@hsc.mb.ca.

    Source

    MeSH

    Adult
    Age Factors
    Aged
    Anxiety
    Awareness
    Cohort Studies
    Delivery of Health Care
    Depression
    Disability Evaluation
    Female
    Humans
    Male
    Mental Health
    Middle Aged
    Multiple Sclerosis
    Principal Component Analysis
    Psychiatric Status Rating Scales

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30096684

    Citation

    Orr, Justine, et al. "Factors Associated With Perceived Need for Mental Health Care in Multiple Sclerosis." Multiple Sclerosis and Related Disorders, vol. 25, 2018, pp. 179-185.
    Orr J, Bernstein CN, Graff LA, et al. Factors associated with perceived need for mental health care in multiple sclerosis. Mult Scler Relat Disord. 2018;25:179-185.
    Orr, J., Bernstein, C. N., Graff, L. A., Patten, S. B., Bolton, J. M., Sareen, J., ... Marrie, R. A. (2018). Factors associated with perceived need for mental health care in multiple sclerosis. Multiple Sclerosis and Related Disorders, 25, pp. 179-185. doi:10.1016/j.msard.2018.07.043.
    Orr J, et al. Factors Associated With Perceived Need for Mental Health Care in Multiple Sclerosis. Mult Scler Relat Disord. 2018;25:179-185. PubMed PMID: 30096684.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Factors associated with perceived need for mental health care in multiple sclerosis. AU - Orr,Justine, AU - Bernstein,Charles N, AU - Graff,Lesley A, AU - Patten,Scott B, AU - Bolton,James M, AU - Sareen,Jitender, AU - Marriott,James J, AU - Fisk,John D, AU - Marrie,Ruth Ann, AU - ,, Y1 - 2018/07/29/ PY - 2018/05/22/received PY - 2018/07/22/revised PY - 2018/07/27/accepted PY - 2018/8/11/pubmed PY - 2018/12/19/medline PY - 2018/8/11/entrez KW - Anxiety KW - Depression KW - Mental health KW - Multiple sclerosis KW - Perceived need SP - 179 EP - 185 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 25 N2 - BACKGROUND: Within the multiple sclerosis (MS) population, depression and anxiety are highly prevalent comorbidities that are associated with adverse outcomes such as diminished quality of life and disability progression. In the general population, many people who do not meet formal diagnostic criteria for depression or anxiety disorders still identify a need for mental health care. Limited data are available regarding the perceived need for mental health care among persons with MS. OBJECTIVE: We aimed to determine factors associated with a perceived need for mental health care in the MS population. METHODS: Participants with MS completed the Hospital Anxiety and Depression Scale (HADS) to assess severity of depression and anxiety symptoms, and reported whether they perceived a need for mental health care, in the context of a larger study examining the burden of psychiatric disorders in immune-mediated inflammatory disease. Participants were also evaluated using the Structured Clinical Interview for DSM-IV-TR (SCID) to diagnose depression or anxiety disorders. Participants reported their sociodemographic characteristics, and underwent physical assessments to determine their disability status. Descriptive analyses and binary logistic regression models were used to determine sociodemographic and clinical factors associated with perceived need for mental health care. RESULTS: Of 255 participants enrolled, 251 were included in this analysis. Most participants were women, Caucasian, with post-secondary education, with a mean (SD) age at enrollment of 50.9 (12.9) years. They predominantly had a relapsing-remitting MS course. Nearly one-quarter of participants had a current SCID diagnosis of depression or anxiety (n = 57, 22.7%). Overall, 31.8% (n = 80) of participants reported a need for mental health care. These individuals were slightly younger at enrollment (p = 0.037), but otherwise did not differ with respect to sociodemographic characteristics, compared to participants not reporting this need. Those identifying need for mental health care also had an earlier age of MS symptom onset (p = 0.011). After adjusting for sociodemographic and clinical factors, elevated symptoms of depression (odds ratio [OR] 2.36; 95%CI: 1.06, 5.25) and anxiety (OR 6.08; 95%CI: 2.78, 13.3) were associated with an increased likelihood of reporting a need for mental health care. Any current SCID diagnosis of depression or anxiety was not associated with perceived need for mental health care after accounting for symptoms of depression and anxiety. CONCLUSIONS: One-third of people with MS identified a need for mental health care. Symptoms of anxiety and depression, but not current diagnosed mental health disorders, were the predominant factors associated with a perceived need for care. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/30096684/Factors_associated_with_perceived_need_for_mental_health_care_in_multiple_sclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(18)30263-3 DB - PRIME DP - Unbound Medicine ER -