Contributions
Abstract: P380
Type: Poster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Background: The Hospital Anxiety and Depression Scale (HADS) has been validated for use in people with multiple sclerosis (MS). However, scores on the depression subscale may be influenced by physical factors because of one question: 'I feel as if I am slowed down.'
Objective: To determine the usefulness of the HADS with and without the 'slowed down' question in detecting depression and predicting cognitive dysfunction.
Methods: A sample of 193 people with confirmed MS completed the HADS. Previously established cut-off scores for the HADS - depression subscale with and without the 'slowed down' question included were used to classify depressed participants. The Minimal Assessment of Cognitive Functioning in MS battery was administered to all participants. Two linear regression models were conducted to determine predictors of information processing speed, learning/memory, and executive function. In model 1 predictors included HADS - depression with the 'slowed down' question, HADS - anxiety, EDSS, physical domain of the modified Fatigue Impact Scale (m-FIS), age, and premorbid IQ based on the Wechsler Test of Adult Reading (WTAR). In model 2 the 'slowed down' question was excluded from the HADS - depression. Statistical significance was set at p< 0.05.
Results: The mean age of the sample was 43.62 years (SD: 10.67) and consisted of 136 (70.5%) females. The HADS - depression with and without the 'slowed down' question detected similar rates of depression (30.6% vs. 31.6%, respectively). The internal consistency of the HADS - depression was similar with and without the 'slowed down' question (Cronbach alpha: 0.80 and 0.80, respectively). Based on model 1, significant predictors of processing speed were EDSS, premorbid IQ, and HADS - depression; of memory EDSS, age, premorbid IQ, and HADS - depression; of executive function age, premorbid IQ, and HADS - depression. After removing the 'slowed down' question in model 2, HADS - depression no longer predicted processing speed and memory. The only significant correlation between the EDSS and the individual HADS - depression questions was with the psychomotor slowing item (r=0.20, p=0.009).
Conclusion: Removing the 'slowed down' question from the HADS - depression subscale does not influence its internal consistency. The depression subscale is a better predictor of cognition with the question included, however, this relationship may be driven by factors other than depression.
Disclosure:
Viral Patel: Nothing to disclose
Lisa Walker: Nothing to disclose
Anthony Feinstein: has served on scientific advisory boards for Merck Serono and Avanir Pharmaceuticals; has received speaker honoraria from Merck Serono, Teva Pharmaceuticals Industries Ltd., Novartis, and Biogen Idec; serves on the editorial boards of Multiple Sclerosis; receives publishing royalties for The Clinical Neuropsychiatry of Multiple Sclerosis (Cambridge University Press, 2007); chairs the Medical Advisory Committee for the Multiple Sclerosis Society of Canada; conducts neuropsychiatric evaluation, cognitive testing, and brain imaging in neuropsychiatry in his clinical practice, and receives research support from the Canadian Institute of Health Research and the Multiple Sclerosis Society of Canada.
Source of funding: Multiple Sclerosis Society of Canada
Abstract: P380
Type: Poster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Background: The Hospital Anxiety and Depression Scale (HADS) has been validated for use in people with multiple sclerosis (MS). However, scores on the depression subscale may be influenced by physical factors because of one question: 'I feel as if I am slowed down.'
Objective: To determine the usefulness of the HADS with and without the 'slowed down' question in detecting depression and predicting cognitive dysfunction.
Methods: A sample of 193 people with confirmed MS completed the HADS. Previously established cut-off scores for the HADS - depression subscale with and without the 'slowed down' question included were used to classify depressed participants. The Minimal Assessment of Cognitive Functioning in MS battery was administered to all participants. Two linear regression models were conducted to determine predictors of information processing speed, learning/memory, and executive function. In model 1 predictors included HADS - depression with the 'slowed down' question, HADS - anxiety, EDSS, physical domain of the modified Fatigue Impact Scale (m-FIS), age, and premorbid IQ based on the Wechsler Test of Adult Reading (WTAR). In model 2 the 'slowed down' question was excluded from the HADS - depression. Statistical significance was set at p< 0.05.
Results: The mean age of the sample was 43.62 years (SD: 10.67) and consisted of 136 (70.5%) females. The HADS - depression with and without the 'slowed down' question detected similar rates of depression (30.6% vs. 31.6%, respectively). The internal consistency of the HADS - depression was similar with and without the 'slowed down' question (Cronbach alpha: 0.80 and 0.80, respectively). Based on model 1, significant predictors of processing speed were EDSS, premorbid IQ, and HADS - depression; of memory EDSS, age, premorbid IQ, and HADS - depression; of executive function age, premorbid IQ, and HADS - depression. After removing the 'slowed down' question in model 2, HADS - depression no longer predicted processing speed and memory. The only significant correlation between the EDSS and the individual HADS - depression questions was with the psychomotor slowing item (r=0.20, p=0.009).
Conclusion: Removing the 'slowed down' question from the HADS - depression subscale does not influence its internal consistency. The depression subscale is a better predictor of cognition with the question included, however, this relationship may be driven by factors other than depression.
Disclosure:
Viral Patel: Nothing to disclose
Lisa Walker: Nothing to disclose
Anthony Feinstein: has served on scientific advisory boards for Merck Serono and Avanir Pharmaceuticals; has received speaker honoraria from Merck Serono, Teva Pharmaceuticals Industries Ltd., Novartis, and Biogen Idec; serves on the editorial boards of Multiple Sclerosis; receives publishing royalties for The Clinical Neuropsychiatry of Multiple Sclerosis (Cambridge University Press, 2007); chairs the Medical Advisory Committee for the Multiple Sclerosis Society of Canada; conducts neuropsychiatric evaluation, cognitive testing, and brain imaging in neuropsychiatry in his clinical practice, and receives research support from the Canadian Institute of Health Research and the Multiple Sclerosis Society of Canada.
Source of funding: Multiple Sclerosis Society of Canada