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Freedman DE, Oh J, Kiss A, Puopolo J, Wishart M, Meza C, Feinstein A. The influence of depression and anxiety on cognition in people with multiple sclerosis: a cross-sectional analysis. J Neurol 2024; 271:4885-4896. [PMID: 38730098 DOI: 10.1007/s00415-024-12409-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/04/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
There are conflicting findings about the relationships between depression, anxiety, and cognitive dysfunction in people with multiple sclerosis (MS), and a paucity of research has examined the cumulative influence on cognition of depression plus anxiety. This study aimed to determine whether elevated symptoms of depression and anxiety alone or in combination are associated with worse cognition in people with MS. In this cross-sectional analysis, people with MS consecutively seen at a tertiary neuropsychiatry clinic completed the Hospital Anxiety and Depression Scale for symptoms of depression (HADS-D) and anxiety (HADS-A), and the Minimal Assessment of Cognitive Function in MS for cognitive indices. Accounting for covariates, regression models predicted cognitive indices from scores for HADS-D, HADS-A, and the interaction. Of 831 people with MS, 72% were female, mean age was 43.2 years, and median Expanded Disability Status Scale score was 2.0. Depressive symptoms were independently predictive of lower verbal fluency (Controlled Oral Word Association Test, p < 0.01), verbal learning (California Verbal Learning Test-II (CVLT-II) total learning, p = 0.02), verbal delayed recall (CVLT-II delayed recall, p < 0.01), and processing speed (Symbol Digit Modalities Test, p < 0.01; three-second Paced Auditory Serial Addition Test (PASAT), p = 0.05; two-second PASAT, p = 0.01). Anxiety in people with depression predicted decreased visuospatial function (Judgment of Line Orientation, p = 0.05), verbal learning (p < 0.01), verbal delayed recall (p < 0.01), visuospatial recall (Brief Visuospatial Memory Test-Revised, p = 0.02), and executive function (Delis-Kaplan Executive Function System, p < 0.01). Anxiety alone was not independently predictive of cognition. In conclusion, depression, especially with comorbid anxiety, is associated with cognitive dysfunction in people with MS.
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Affiliation(s)
- David E Freedman
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Jiwon Oh
- Division of Neurology, Department of Medicine, Temerty Faculty of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Alex Kiss
- Evaluative Clinical Sciences, Department of Health Policy, Management and Evaluation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Juliana Puopolo
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Margaret Wishart
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Cecilia Meza
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Anthony Feinstein
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
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Wang H, Wen Z, Wang Y, Liu X, Xie J. The association between procrastination in academic writing and negative emotional states during the COVID-19 pandemic: the indirect effects of stress coping styles and self-efficacy. ANXIETY, STRESS, AND COPING 2024:1-14. [PMID: 38602251 DOI: 10.1080/10615806.2024.2339985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND OBJECTIVES Limited research has examined the mediating mechanisms underlying the association between procrastination in academic writing and negative emotional states during the COVID-19 pandemic. In the present study, we examined whether stress coping styles and self-efficacy for self-regulation of academic writing mediated the relationship between procrastination in academic writing and negative emotional states. DESIGN AND METHOD Graduate students (N = 475, 61.7% female, Mage of students at baseline = 29.02 years, SD = 5.72) completed questionnaires at Time 1 (March 2020; Procrastination in Academic Writing and Coping Inventory for Stressful Situations), and Time 2 (June 2020; The Self-Efficacy for Self-Regulation of Academic Writing Scale and Depression, Anxiety, and Stress Scale - 21). RESULTS Emotion-oriented coping and the self-efficacy for self-regulation of academic writing serially mediated the association between procrastination in academic writing and negative emotional states. Meanwhile, task-oriented coping and self-efficacy for self-regulation of academic writing also serially mediated the association between procrastination in academic writing and negative emotional states. CONCLUSIONS These findings provide a plausible explanation of the roles that stress coping styles and self-efficacy for self-regulation of academic writing play in the association between procrastination in academic writing and negative emotional states.
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Affiliation(s)
- Huihui Wang
- College of Teacher Education, Ningxia University, Yinchuan, People's Republic of China
| | - Zhonglin Wen
- Center for Studies of Psychological Application/School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Yang Wang
- School of Public Administration, Guangdong University of Finance, Guangzhou, People's Republic of China
| | - Xiqin Liu
- School of Foreign Languages, South China University of Technology, Guangzhou, People's Republic of China
| | - Jinyan Xie
- Center for Studies of Psychological Application/School of Psychology, South China Normal University, Guangzhou, People's Republic of China
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Bahmani B, Mehraban S, Carnero Contentti E, Azkhosh M, Khanjani M, Azimian M. Relationship of coping strategies with mood symptoms, disease related characteristics and demographic variables in patients with multiple sclerosis: A systematic review study. Mult Scler Relat Disord 2022; 67:104163. [PMID: 36126537 DOI: 10.1016/j.msard.2022.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/13/2022] [Accepted: 09/05/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE the aim of this systematic review was to summarize the coping strategies utilized by people with multiple sclerosis (pwMS) and the association of these strategies with mood symptoms, quality of life, fatigue and disability in pwMS. METHODS search in the literature was performed across electronic databases of PubMed, Web of Science, and Scopus. No time constraint was applied for searching across the databases. Manual search was also performed on the list of references of the retrieved papers. Two authors independently evaluated the retrieved citations based on predetermined inclusion criteria in two screening stages. This systematic review followed Joanna Briggs Institute (JBI) guidelines for cross-sectional research. The findings related to the coping patterns against MS as well as the relationship between the patterns and MS symptoms were extracted and synthesized. FINDINGS A total of 2390 records were identified. After removing duplicates and based on screening, 39 papers met the eligibility criteria for qualitative synthesis, and they were evaluated in terms of quality of study. When comparing genders, women used more religious coping, social support seeking, and positive coping compared to men. Depression and anxiety were associated with maladaptive and emotion-oriented coping strategies. The patients who used positive and problem solving oriented coping strategies had a better score of quality of life. Disability and fatigue were associated with applying avoidance and maladaptive coping strategies. CONCLUSION the findings of this review suggest that understanding the relationship between coping strategies and quality of life as well as the symptoms related to the disease is important to understand development of psychological interventions adopted by specialists to support these patients.
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Affiliation(s)
- Bahman Bahmani
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shafigh Mehraban
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Manouchehr Azkhosh
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadsaeed Khanjani
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojtaba Azimian
- Department of Clinical Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Concerto C, Rodolico A, Ciancio A, Messina C, Natale A, Mineo L, Battaglia F, Aguglia E. Vitamin D and Depressive Symptoms in Adults with Multiple Sclerosis: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:199. [PMID: 35010459 PMCID: PMC8750302 DOI: 10.3390/ijerph19010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Vitamin D deficiency has been correlated with Multiple Sclerosis (MS) risk and disease activity. There is some controversy as to whether vitamin D could have an impact on depressive symptoms in people with MS (pwMS). The aim of this scoping review was to evaluate the association between vitamin D status and depressive symptoms in pwMS. METHODS We searched databases to include studies published up to March 2021 to provide an overview of the available evidence on the correlation between vitamin D status and depressive symptoms in pwMS. The eligibility criteria were as follows: studies evaluating the use of vitamin D measurement on depressive symptoms in patients suffering from MS, including randomized and non-randomized studies; studies written in English; and studies exploring an adult population over the age of 18. RESULTS Eleven studies met our inclusion criteria: two of them were abstracts only; the majority were cross-sectional studies; two were prospective longitudinal studies; one was a retrospective cohort study; and one was a randomized placebo-controlled trial (RCT). Of the eleven studies selected, seven showed a potential correlation between low vitamin D levels and depressive symptoms. CONCLUSION Future RCT studies should include patients with greater severity of depressive symptoms and should consider confounding factors such as sun exposure and seasonal variation of vitamin D.
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Affiliation(s)
- Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Alessia Ciancio
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Christian Messina
- MS Center, Department “G.F. Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy;
| | - Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Ludovico Mineo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Fortunato Battaglia
- Department of Medical Sciences, Neurology and Psychiatry, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA;
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
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Van Herck M, Goërtz YMJ, Houben-Wilke S, Machado FVC, Meys R, Delbressine JM, Vaes AW, Burtin C, Posthuma R, Franssen FME, Hajian B, Vijlbrief H, Spies Y, van 't Hul AJ, Janssen DJA, Spruit MA. Severe Fatigue in Long COVID: Web-Based Quantitative Follow-up Study in Members of Online Long COVID Support Groups. J Med Internet Res 2021; 23:e30274. [PMID: 34494964 PMCID: PMC8457337 DOI: 10.2196/30274] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/31/2021] [Accepted: 08/29/2021] [Indexed: 12/13/2022] Open
Abstract
Background Fatigue is the most commonly reported symptom in patients with persistent complaints following COVID-19 (ie, long COVID). Longitudinal studies examining the intensity of fatigue and differentiating between physical and mental fatigue are lacking. Objective The objectives of this study were to (1) assess the severity of fatigue over time in members of online long COVID peer support groups, and (2) assess whether members of these groups experienced mental fatigue, physical fatigue, or both. Methods A 2-wave web-based follow-up study was conducted in members of online long COVID peer support groups with a confirmed diagnosis approximately 3 and 6 months after the onset of infectious symptoms. Demographics, COVID-19 diagnosis, received health care (from medical professionals or allied health care professionals), fatigue (Checklist Individual Strength–subscale subjective fatigue [CIS-Fatigue]; 8-56 points), and physical and mental fatigue (self-constructed questions; 3-21 points) were assessed. Higher scores indicated more severe fatigue. A CIS-Fatigue score ≥36 points was used to qualify patients as having severe fatigue. Results A total of 239 patients with polymerase chain reaction/computed tomography–confirmed COVID-19 completed the survey 10 weeks (SD 2) and 23 weeks (SD 2) after onset of infectious symptoms, respectively (T1 and T2). Of these 239 patients, 198 (82.8%) were women; 142 (59.4%) had no self-reported pre-existing comorbidities; 208 (87%) self-reported being in good health before contracting COVID-19; and 62 (25.9%) were hospitalized during acute infection. The median age was 50 years (IQR 39-56). The vast majority of patients had severe fatigue at T1 and T2 (n=204, 85.4%, and n=188, 78.7%, respectively). No significant differences were found in the prevalence of normal, mild, and severe fatigue between T1 and T2 (P=.12). The median CIS-Fatigue score was 48 points (IQR 42-53) at T1, and it decreased from T1 to T2 (median change: –2 points, IQR –7 to 3; P<.001). At T1, a median physical fatigue score of 19 points (IQR 16-20) and a median mental fatigue score of 15 points (IQR 10-17) were reported; these scores were lower at T2 for physical but not for mental fatigue (median change for physical fatigue –1 point, IQR –3 to 0, P<.001; median change for mental fatigue 0 points, IQR –3 to 3, P=.52). At the time of completing the follow-up survey, 194/239 (81.2%) and 164/239 (68.6%) of all patients had received care from at least one medical professional and one allied health care professional, respectively. Conclusions Fatigue in members of online long COVID support groups with a confirmed COVID-19 diagnosis decreases from 10 to 23 weeks after onset of symptoms. Despite this, severe fatigue remains highly prevalent. Both physical and mental fatigue are present. It remains unclear whether and to what extent fatigue will resolve spontaneously in the longer term. Trial Registration Netherlands Trial Register NTR8705; https://www.trialregister.nl/trial/8705.
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Affiliation(s)
- Maarten Van Herck
- REVAL Rehabilitation Research Center, BIOMED Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Yvonne M J Goërtz
- Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | | | - Felipe V C Machado
- Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Roy Meys
- Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | | | - Anouk W Vaes
- Department of Research and Development, Ciro, Horn, Netherlands
| | - Chris Burtin
- REVAL Rehabilitation Research Center, BIOMED Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Rein Posthuma
- Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Frits M E Franssen
- Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Bita Hajian
- Department of Research and Development, Ciro, Horn, Netherlands
| | | | - Yvonne Spies
- Lung Foundation Netherlands, Amersfoort, Netherlands
| | - Alex J van 't Hul
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, Netherlands
| | - Daisy J A Janssen
- Department of Research and Development, Ciro, Horn, Netherlands.,Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, Netherlands.,Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
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