2018 study: factors x mental health care needs in MS

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2018 study: factors x mental health care needs in MS

Postby jimmylegs » Sun Sep 30, 2018 11:24 am

Factors associated with perceived need for mental health care in multiple sclerosis (2018)
https://www.sciencedirect.com/science/a ... 4818302633

Highlights
•One-third of people with MS identified a need for mental health treatment.
•Symptoms of anxiety and depression were the predominant factors associated with a reported need for treatment.
•Older age was associated with a reduced need for mental health treatment.

Abstract
Background
Within the multiple sclerosis (MS) population, depression and anxiety are highly prevalent comorbidities that are associated with adverse outcomes such as diminished quality of life and disability progression. In the general population, many people who do not meet formal diagnostic criteria for depression or anxiety disorders still identify a need for mental health care. Limited data are available regarding the perceived need for mental health care among persons with MS.

Objective
We aimed to determine factors associated with a perceived need for mental health care in the MS population.

Methods
Participants with MS completed the Hospital Anxiety and Depression Scale (HADS) to assess severity of depression and anxiety symptoms, and reported whether they perceived a need for mental health care, in the context of a larger study examining the burden of psychiatric disorders in immune-mediated inflammatory disease. Participants were also evaluated using the Structured Clinical Interview for DSM-IV-TR (SCID) to diagnose depression or anxiety disorders. Participants reported their sociodemographic characteristics, and underwent physical assessments to determine their disability status. Descriptive analyses and binary logistic regression models were used to determine sociodemographic and clinical factors associated with perceived need for mental health care.

Results
Of 255 participants enrolled, 251 were included in this analysis. Most participants were women, Caucasian, with post-secondary education, with a mean (SD) age at enrollment of 50.9 (12.9) years. They predominantly had a relapsing-remitting MS course. Nearly one-quarter of participants had a current SCID diagnosis of depression or anxiety (n = 57, 22.7%). Overall, 31.8% (n = 80) of participants reported a need for mental health care. These individuals were slightly younger at enrollment (p = 0.037), but otherwise did not differ with respect to sociodemographic characteristics, compared to participants not reporting this need. Those identifying need for mental health care also had an earlier age of MS symptom onset (p = 0.011). After adjusting for sociodemographic and clinical factors, elevated symptoms of depression (odds ratio [OR] 2.36; 95%CI: 1.06, 5.25) and anxiety (OR 6.08; 95%CI: 2.78, 13.3) were associated with an increased likelihood of reporting a need for mental health care. Any current SCID diagnosis of depression or anxiety was not associated with perceived need for mental health care after accounting for symptoms of depression and anxiety.

Conclusions
One-third of people with MS identified a need for mental health care. Symptoms of anxiety and depression, but not current diagnosed mental health disorders, were the predominant factors associated with a perceived need for care.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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jimmylegs
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