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Anxiety and Depression Linked to Cognitive Problems in MS and Other Disorders, Says New Study

January 29, 2019

SUMMARY

  • Researchers compared the association of depression and anxiety with results of cognitive tests in people with MS, inflammatory bowel disease and rheumatoid arthritis, and in anxious/depressed individuals who didn’t have an inflammatory disorder.
  • In people with any of the disorders, higher levels of anxiety were associated with slower information processing speed, decreased verbal learning, and decreased working memory. Higher levels of depression were associated with decreased information processing speed.
  • These findings emphasize the importance of recognizing and managing anxiety and depression, which may reduce their impacts on cognitive functions.
  • The study was funded by the Canadian Institutes of Health Research, Crohn’s and Colitis Canada, and the Waugh Family Chair in MS at the University of Manitoba. The team (Christiane E. Whitehouse, BSc, a PhD, Dalhousie University, Halifax, Nova Scotia,  Ruth Ann Marrie, MD, PhD, University of Manitoba, Winnipeg) and others published their findings in Neurology (published online January 29, 2019).

DETAILS

Background: Depression and anxiety are commonly experienced symptoms in people who have multiple sclerosis. Several studies have suggested that depression and anxiety affect cognition (mental processes and actions), although findings have been inconsistent. This is important because impairment of cognitive functions -- including information processing speed, verbal learning, executive function, and recall and/or working memory -- affects the majority of individuals living with MS and can impact their relationships, employment, and many other activities. If there is a connection, interventions that address depression and anxiety may help to diminish their negative impacts on cognitive functions and on quality of life.

The Study: Investigators compared the association of depression and anxiety with cognitive impairment in people with MS and other inflammatory disorders (inflammatory bowel disease and rheumatoid arthritis), as well as on people who have depression and anxiety but not an inflammatory disease. A total of 964 participants from Manitoba, Canada, split among the four conditions, completed a psychiatric interview and psychological and cognitive tests. Participants were predominantly female Caucasians, with an average age from 43 to 59. Three-quarters of the participants with MS had relapsing-remitting MS, just under 20% had secondary progressive MS, and 9% had primary progressive MS.

Results: In all groups, higher levels of anxiety were associated with slower information processing speed, and decreases in verbal learning and working memory performance. Higher levels of depression were associated with slower information processing speed. All four groups showed more cognitive impairment than normally observed in the general population.

Experiencing both anxiety and depression was not more likely than either condition alone to predict cognitive deficits.

The study’s limitations include a lack of healthy controls, as well as having more women than men without looking at sex-specific risks for cognitive problems.

The team (Christiane E. Whitehouse, BSc, a PhD, Dalhousie University, Halifax, Nova Scotia, and Ruth Ann Marrie, MD, PhD, University of Manitoba, Winnipeg) and others published their findings in Neurology (published online January 29, 2019).

Conclusions: The results show that problems in thinking and remembering may, in part, be related to having anxiety and/or depression. Further research is needed to determine whether successfully treating anxiety and depression can reduce their impacts on cognitive functions. The National MS Society is funding several studies on psychosocial issues in MS, including a study testing an online program for reducing depression.

The findings emphasize the importance of recognizing and managing anxiety and depression, particularly anxiety which has received less attention than depression in studies of MS. Fortunately, treatments are available to diminish the effects of depression and anxiety. Professional counseling and support groups can be very helpful in dealing with these symptoms, and medication may also be needed to obtain relief.

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Learn more about emotional health

Learn about cognitive changes

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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