Related Experiment Video
Updated: Dec 7, 2025
Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis
Published on: September 9, 2022
Anxiety and depression affect performance on the symbol digit modalities test over time in MS and other immune
Ruth Ann Marrie1, Ronak Patel2, Charles N Bernstein3
1Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada/Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Background:
Longitudinal studies assessing depression and anxiety effects on cognition in multiple sclerosis (MS) are limited.
Objective:
We tested whether within-person fluctuations in symptoms of depression or anxiety over time affect cognition in persons with MS, inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and a lifetime history of depression/anxiety disorders (DEP/ANX) but without an immune-mediated inflammatory diseases (IMID).
Methods:
We followed participants (MS: 255, IBD: 247, RA: 154, and DEP/ANX: 306) for 3 years. Annually, they completed the hospital anxiety and depression scale (HADS) and cognitive tests including the symbol digit modalities test (SDMT). We evaluated associations of elevated symptoms (scores ⩾ 11) of anxiety (HADS-A) and depression (HADS-D) with SDMT z-scores using multivariable linear models-estimating between-person and within-person effects.
Results:
Participants with MS performed worse on the SDMT than participants in the DEP/ANX cohort (β = -0.68; 95% CI: -0.88, -0.48). Participants with elevated HADS-A scores performed worse on the SDMT than those without elevated scores (β = -0.43; 95% CI: -0.65, -0.21), particularly those with RA. Time-varying within-person elevations in depressive symptoms were associated with worse SDMT performance (β = -0.12; 95% CI: -0.21, -0.021).
Conclusions:
Across persons, elevated symptoms of anxiety adversely affected information processing. Elevated symptoms of depression within-persons over time were associated with declines in information processing speed.
