Clinical correlates of state and trait anxiety in multiple sclerosis.

Background: Anxiety represents one of the most prevalent psychiatric symptoms in multiple sclerosis (MS), impacting the overall disease burden and quality of life. This psychopathological feature can be expressed as state (S-ANX) and trait (T-ANX) anxiety, but few studies specifically evaluated these two components in MS. The present study was aimed at investigating the prevalence and specific correlates of S-ANX and T-ANX in a cohort of people with MS (PwMS).
Methods: 88 in- and out-patients with MS were consecutively recruited. S-ANX and T-ANX were evaluated with the two subscales of the State and Trait Anxiety Inventory. Bivariate analyses were performed to compare PwMS who displayed clinically significant S-ANX and T-ANX and those who did not. Two logistic regression models were run in order to identify variables significantly associated with S-ANX and T-ANX.
Results: S-ANX and T-ANX presented a prevalence of 42% and 45.5%, respectively. S-ANX was more frequent in subjects hospitalized due to recent MS onset. PwMS and S-ANX more frequently had a recent relapse, as well as evidence of disease activity on brain magnetic resonance imaging. Subjects with T-ANX were more often females and displayed higher severity of fatigue. Depressive features at the Beck Depression Inventory were more severe in both S-ANX and T-ANX subjects. PwMS with S-ANX reported a higher prevalence of T-ANX and vice versa. At the logistic regressions, depression severity displayed a significant association with S-ANX and T-ANX. We also detected positive associations between S-ANX and inpatient status, as well as between T-ANX and female sex.
Conclusion: Both S-ANX and T-ANX are highly prevalent features in PwMS. These two components of anxiety should be adequately identified and discriminated in the clinical practice. The higher severity of depression in PwMS with clinically significant anxiety should not be neglected.
Competing Interests: Declaration of interests LGe, SS, EDS, EC, NS, and LP have no conflicts of interest to declare. GM received travel grants from Janssen (unrelated to the present work). LGa participated on advisory boards for, and received writing honoraria and travel grants from Almirall, Biogen, Euroimmun, Fujirebio, Merck, Mylan, Novartis, Roche, Sanofi, and Teva. AM received travel grants and writing honoraria from Almirall, Biogen, Merck, Mylan, Novartis, Sanofi Genzyme, and Teva. AT received research support from Lundbeck and served as speaker for Lundbeck and Angelini (unrelated to the present work). MDF participated on advisory boards for and received speaker or writing honoraria, research support and funding for travelling from Bayer, Biogen Idec, Genzyme, Merck, Mylan, Novartis, Roche, Siemens Healthineers, Teva and Viatris.
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