Abstract
BackgroundThe prevalence of depression in people with multiple sclerosis (PwMS) is high; however, symptoms common to both conditions makes measurement difficult. There is no high quality overview of validation studies to guide the choice of depression inventory for this population.MethodsA systematic review of studies validating the use of generic depression inventories in people with MS was conducted using MEDLINE and PsycINFO. Studies validating the use of depression inventories in PwMS and published in English were included; validation studies of tests for cognitive function and general mental health were excluded. Eligible studies were then quality assessed using the COSMIN checklist and findings synthesised narratively by instrument and validity domain.ResultsTwenty-one studies (N = 5,991 PwMS) evaluating 12 instruments were included in the review. Risk of bias varied greatly between instrument and validity domain.ConclusionsThe review of validation studies was constrained by poor quality reporting and outcome reporting bias. Well-conducted evaluations of some instruments are unavailable for some validity domains. This systematic review provides an evidence base for trade-offs in the selection of an instrument for assessing self-reported symptoms of depression in research or clinical practice involving people with MS. We make detailed and specific recommendations for where further research is needed.Trial RegistrationPROSPERO CRD42014010597
Highlights
The prevalence of depression in people with multiple sclerosis (PwMS) is high; symptoms common to both conditions makes measurement difficult
Principal Findings we summarise the evidence for dimensions of validity across different instruments, referring in brackets to the number of participants and the COSMINrated quality of each study
All instruments identified in this review need further work on validation and reliability for use in people with Multiple sclerosis (MS)
Summary
The prevalence of depression in people with multiple sclerosis (PwMS) is high; symptoms common to both conditions makes measurement difficult. Multiple sclerosis (MS) is a chronic condition affecting the central nervous system It is characterised by neurological symptoms and deficits that lead to increased disability and physical decline over 30–40 years [1]. The prevalence of depression, which is strongly linked with a reduced quality of life, is high amongst people with MS (PwMS) with around half having major depression at some point in there is significant overlap in the somatic symptoms common to depression and MS, principally fatigue, pain, poor sleep and concentration, leading to concerns over the measurement of depression in PwMS [5]. The debate over how to assesses depression in the presence of a physical condition
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