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Modifiable factors associated with depression and anxiety in multiple sclerosis.
Acta Neurol Scand 2019; 140(3):204-211AN

Abstract

OBJECTIVES

Modifiable lifestyle factors are implicated in multiple sclerosis (MS) symptoms but their role in mood is unclear. This study aimed to investigate associations between lifestyle and depression and anxiety in Australian participants with MS.

MATERIALS AND METHODS

Self-reported data from the Australian Multiple Sclerosis Longitudinal Study included the Hospital Anxiety and Depression Scale (HADS) and lifestyle measurements from 1500 participants. SNAP score (range 0-5) was the sum of non-smoking, sufficient fruit/vegetable intake, non-hazardous alcohol consumption, sufficient physical activity and healthy BMI. Analyses by log-binomial and linear regression were adjusted for confounding.

RESULTS

Symptoms of depression and anxiety were prevalent in 27% and 40%, respectively; 20% had both. Mean SNAP score was 2.7/5; only 3% met all healthy lifestyle recommendations. Only 10% reported adequate fruit/vegetable intake, and 22% reported a combination of unhealthy BMI, inadequate physical activity and inadequate nutrition. A healthier SNAP score was associated with lower depression prevalence (adjusted prevalence ratio 0.83 [95% CI 0.75, 0.92] per unit increase) and depression severity (adjusted β-0.44 [95% CI -0.64, -0.24]), but not with anxiety.

CONCLUSIONS

Modifiable lifestyle factors are associated with lower frequency and severity of depression, but not anxiety, in Australian people with multiple sclerosis. The associations between a healthier SNAP score and lower depression are likely bi-directional. SNAP risk factor prevalence and co-occurrence, especially inadequate nutrition and low physical activity, were high among Australians with MS.

Authors+Show Affiliations

Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31121055

Citation

Gascoyne, Claudia R., et al. "Modifiable Factors Associated With Depression and Anxiety in Multiple Sclerosis." Acta Neurologica Scandinavica, vol. 140, no. 3, 2019, pp. 204-211.
Gascoyne CR, Simpson S, Chen J, et al. Modifiable factors associated with depression and anxiety in multiple sclerosis. Acta Neurol Scand. 2019;140(3):204-211.
Gascoyne, C. R., Simpson, S., Chen, J., van der Mei, I., & Marck, C. H. (2019). Modifiable factors associated with depression and anxiety in multiple sclerosis. Acta Neurologica Scandinavica, 140(3), pp. 204-211. doi:10.1111/ane.13132.
Gascoyne CR, et al. Modifiable Factors Associated With Depression and Anxiety in Multiple Sclerosis. Acta Neurol Scand. 2019;140(3):204-211. PubMed PMID: 31121055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modifiable factors associated with depression and anxiety in multiple sclerosis. AU - Gascoyne,Claudia R, AU - Simpson,Steve,Jr AU - Chen,Jing, AU - van der Mei,Ingrid, AU - Marck,Claudia H, Y1 - 2019/06/24/ PY - 2019/03/15/received PY - 2019/05/06/revised PY - 2019/05/20/accepted PY - 2019/5/24/pubmed PY - 2019/5/24/medline PY - 2019/5/24/entrez KW - SNAP KW - anxiety KW - depression KW - health behaviours KW - lifestyle KW - multiple sclerosis SP - 204 EP - 211 JF - Acta neurologica Scandinavica JO - Acta Neurol. Scand. VL - 140 IS - 3 N2 - OBJECTIVES: Modifiable lifestyle factors are implicated in multiple sclerosis (MS) symptoms but their role in mood is unclear. This study aimed to investigate associations between lifestyle and depression and anxiety in Australian participants with MS. MATERIALS AND METHODS: Self-reported data from the Australian Multiple Sclerosis Longitudinal Study included the Hospital Anxiety and Depression Scale (HADS) and lifestyle measurements from 1500 participants. SNAP score (range 0-5) was the sum of non-smoking, sufficient fruit/vegetable intake, non-hazardous alcohol consumption, sufficient physical activity and healthy BMI. Analyses by log-binomial and linear regression were adjusted for confounding. RESULTS: Symptoms of depression and anxiety were prevalent in 27% and 40%, respectively; 20% had both. Mean SNAP score was 2.7/5; only 3% met all healthy lifestyle recommendations. Only 10% reported adequate fruit/vegetable intake, and 22% reported a combination of unhealthy BMI, inadequate physical activity and inadequate nutrition. A healthier SNAP score was associated with lower depression prevalence (adjusted prevalence ratio 0.83 [95% CI 0.75, 0.92] per unit increase) and depression severity (adjusted β-0.44 [95% CI -0.64, -0.24]), but not with anxiety. CONCLUSIONS: Modifiable lifestyle factors are associated with lower frequency and severity of depression, but not anxiety, in Australian people with multiple sclerosis. The associations between a healthier SNAP score and lower depression are likely bi-directional. SNAP risk factor prevalence and co-occurrence, especially inadequate nutrition and low physical activity, were high among Australians with MS. SN - 1600-0404 UR - https://www.unboundmedicine.com/medline/citation/31121055/Modifiable_factors_associated_with_depression_and_anxiety_in_multiple_sclerosis L2 - https://doi.org/10.1111/ane.13132 DB - PRIME DP - Unbound Medicine ER -