A longitudinal study of depression, anxiety, and disability in multiple sclerosis: Profile and trajectories analyses

Depression and anxiety are prevalent comorbidities in individuals diagnosed with Multiple Sclerosis (MS). Despite this, there is a lack of longitudinal research aimed at exploring the profiles and trajectories of these psychological conditions in this population.

This study had three primary objectives: (1) to identify distinct profiles of depression, anxiety, and disability across three time points; (2) to examine the differences among these profiles with respect to demographic and clinical characteristics; and (3) to examine longitudinal associations and patterns of change in these variables over time.

The study involved 618 adults diagnosed with Relapsing-Remitting MS (RRMS), who reported their levels of depression and anxiety during three scheduled visits to the MS clinic. Additionally, disease disability was quantitatively assessed through a neurological examination incorporating the Expanded Disability Status Scale (EDSS). Principal Components Analysis identified three profiles: Low (n = 280), Moderate (n = 244), and Severe (n = 94), explaining 86.3% of the variance. One-way ANOVA revealed significant differences between clusters for all three variables (p < 0.001), with no significant differences for age, gender, MS duration, and treatment status (p > 0.05). Path analysis highlights two cross-domain paths: from EDSS T1 to depression T2 (β=0.195, p < 0.05), to depression T3 (β=0.457, p < 0.001); and from EDSS T1 to EDSS T2 (β=0.885, p < 0.001), to anxiety T3 (β=-0.378, p < 0.01).

Baseline-defined profiles were consistent with severity strata and were associated with differing longitudinal patterns. These findings highlight the need for routine longitudinal screening of depression and anxiety in MS clinic. This approach is designed to ensure seamless integration into standard neurology consultations, thereby enhancing the overall effectiveness of patient care.