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Modifiable factors associated with depression and anxiety in multiple sclerosis.

Abstract

OBJECTIVES

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

MATERIALS & METHODS

Self-reported data from the Australian Multiple Sclerosis Longitudinal Study included the Hospital Anxiety and Depression Scale (HADS) and lifestyle measurements from 1,500 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

Depression and anxiety was 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, was high among Australians with MS. This article is protected by copyright. All rights reserved.

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  • Authors+Show Affiliations

    ,

    Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne.

    ,

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

    ,

    Menzies Institute for Medical Research, University of Tasmania.

    ,

    Menzies Institute for Medical Research, University of Tasmania.

    Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne. Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne.

    Source

    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, 2019.
    Gascoyne CR, Simpson S, Chen J, et al. Modifiable factors associated with depression and anxiety in multiple sclerosis. Acta Neurol Scand. 2019.
    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, doi:10.1111/ane.13132.
    Gascoyne CR, et al. Modifiable Factors Associated With Depression and Anxiety in Multiple Sclerosis. Acta Neurol Scand. 2019 May 23; 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 - 2019/05/23/ PY - 2019/5/24/entrez PY - 2019/5/24/pubmed PY - 2019/5/24/medline KW - SNAP KW - anxiety KW - depression KW - health behaviours KW - lifestyle KW - multiple sclerosis JF - Acta neurologica Scandinavica JO - Acta Neurol. Scand. N2 - OBJECTIVES: Modifiable lifestyle factors are implicated in multiple sclerosis (MS) symptoms but their role in mood is unclear. This study aims to investigate associations between lifestyle and depression and anxiety in Australian participants with MS. MATERIALS & METHODS: Self-reported data from the Australian Multiple Sclerosis Longitudinal Study included the Hospital Anxiety and Depression Scale (HADS) and lifestyle measurements from 1,500 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: Depression and anxiety was 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, was high among Australians with MS. This article is protected by copyright. All rights reserved. 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 -