Anxiety in multiple sclerosis is related to depressive symptoms and cognitive complaints

Objectives Multiple sclerosis (MS) patients suffer from high levels of anxiety. However, it is unclear which factors are related to anxiety, since study results are inconsistent, and the associated factors have not been examined comprehensively. In this study, we investigated the demographic, disease-related and psychological factors associated with anxiety in MS patients. Materials and methods Cross-sectional data of 119 MS patients were used. Anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), fatigue (Fatigue Severity Scale), cognitive complaints (Cognitive Failures Questionnaire) and cognitive functioning (Wisconsin Card Sorting Test, Controlled Oral Word Association Test, Letter Digit Substitution Test, Concept Shifting Test, Wechsler Memory Test Faces and the Dutch version of the California Verbal Learning Test) were measured. Bivariate and multivariable regression analyses were conducted to test the associations between anxiety and potential contributing factors. Results In this sample, 42% of the MS patients had clinically significant levels of anxiety, defined by a score >= 8 on the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS). A significant correlation was found between anxiety and depressive symptoms, fatigue, cognitive complaints and psychiatric history. In the multivariable analysis, only depressive symptoms and cognitive complaints remained significantly related to anxiety. Conclusions Anxiety is common in MS patients and most strongly related to psychological factors. This knowledge can be taken into account when treating patients with MS. Further research is needed using longitudinal designs and incorporating other factors known to influence anxiety, such as coping, negative affectivity and social support.