Beck Depression Inventory-Fast Screen Research Articles

Huntington Disease Health Related Quality of Life, Function and Well Being: The Patient's Perspective.

Limited information is available on patients' experience living with Huntington's disease (HD). The primary objective of this study was to assess the health-related quality of life and well being of patients with HD. A non-interventional, cross-sectional study was conducted in 17 hospitals-based movement disorders units in Spain. Patients aged≥18years, genetically HD diagnosed [with a diagnostic confidence level score of 4, and an Independence Scale (IS) score≥70] were included. The primary variables were the Huntington's Disease Health-related Quality of Life (HDQLIFE) scores and results of the Satisfaction with Life Scale (SWLS). Secondary outcomes include the Unified HD Rating Scale (UHDRS), Beck Hopelessness Scale (BHS), Stigma Scale for Chronic Illness (SSCI-8), Beck Depression Inventory-Fast Screen (BDI-FS) and Problem Behaviours Assessment for HD short Version (PBA-S). A total of 102 patients were included. The mean age (SD) was 53.1 (12.1) years and 56% were male. Most of the patients (99.0%) showed motor symptoms (87.3%), behavioural and psychiatric disturbances (59.8%), or cognitive impairment (20.6%). HDQLIFE domain score means (SD) includes concern with death and dying 45.97 (9.60) end-of-life planning 37.91 (8.84), and meaning and purpose 44.74 (9.05). SWLS score mean was 24.25 (7.33). Depressive symptoms were found in 37.4% of patients and moderate-to-severe feelings of hopelessness in 32.9%. The prevalence of stigma was 55.9% (n=57). HD impacted quality of life, with prevalent motor, psychiatric symptoms and cognitive impairment. Patient perspectives may provide complementary information to implement specific interventions.

Examining the role of depression on the relationship between performance-based and self-reported cognitive functioning after sport-related concussion.

Little is known about the relationship between neuropsychological test performance, cognitive symptom reporting, and depressive symptoms after sport-related concussion. Accordingly, this cross-sectional study examined these relationships in collegiate athletes. It was hypothesized that depressive symptoms would moderate and mediate the relationship between performance-based and self-reported cognitive functioning after concussion. After sustaining a sport-related concussion, 110 collegiate athletes completed a neuropsychological battery, the Post-Concussion Symptoms Scale, and the Beck Depression Inventory-Fast Screen. Neuropsychological test performance, depressive symptoms, and their interactions were entered into distinct hierarchical linear regression analyses with self-reported cognition as the dependent variable to assess moderation. Mediation was analyzed using the PROCESS macro with 5000 bootstrap samples and a 95% confidence interval. There was a significant interaction between the mean memory composite and depressive symptoms when predicting cognitive symptom reporting, p = 0.047. Simple effects tests revealed that for athletes who had a lower memory composite score, an increase in depressive symptoms led to an increase in self-reported cognitive dysfunction, p < 0.001, ηp2 = 0.11. Depressive symptoms partially mediated the relationship between the memory composite and cognitive symptom reporting, indirect effect = -0.26, 95%CI[-0.58,0.001], but this relationship was not found for any other neurocognitive domain. For tests of memory, depressive symptoms moderated and partially mediated the relationship between performance-based and self-reported cognitive functioning after sport-related concussion. Athletes reporting high depressive symptoms and cognitive dysfunction may need more comprehensive evaluations to inform return-to-play decisions, and depression could be a treatment target for athletes who report high levels of cognitive dysfunction after concussion.

Human restricted CHRFAM7A gene increases brain efficiency.

CHRFAM7A, a uniquely human fusion gene, has been associated with neuropsychiatric disorders including Alzheimer's disease, schizophrenia, anxiety, and attention deficit disorder. Understanding the physiological function of CHRFAM7A in the human brain is the first step to uncovering its role in disease. CHRFAM7A was identified as a potent modulator of intracellular calcium and an upstream regulator of Rac1 leading to actin cytoskeleton reorganization and a switch from filopodia to lamellipodia implicating a more efficient neuronal structure. We performed a neurocognitive-MRI correlation exploratory study on 46 normal human subjects to explore the effect of CHRFAM7A on human brain. Dual locus specific genotyping of CHRFAM7A was performed on genomic DNA to determine copy number (TaqMan assay) and orientation (capillary sequencing) of the CHRFAM7A alleles. As only the direct allele is expressed at the protein level and affects α7 nAChR function, direct allele carriers and non-carriers are compared for neuropsychological and MRI measures. Subjects underwent neuropsychological testing to measure motor (Timed 25-foot walk test, 9-hole peg test), cognitive processing speed (Symbol Digit Modalities Test), Learning and memory (California Verbal Learning Test immediate and delayed recall, Brief Visuospatial Memory Test-Revised immediate and delayed recall) and Beck Depression Inventory-Fast Screen, Fatigue Severity Scale. All subjects underwent MRI scanning on the same 3 T GE scanner using the same protocol. Global and tissue-specific volumes were determined using validated cross-sectional algorithms including FSL's Structural Image Evaluation, using Normalization, of Atrophy (SIENAX) and FSL's Integrated Registration and Segmentation Tool (FIRST) on lesion-inpainted images. The cognitive tests were age and years of education-adjusted using analysis of covariance (ANCOVA). Age-adjusted analysis of covariance (ANCOVA) was performed on the MRI data. CHRFAM7A direct allele carrier and non-carrier groups included 33 and 13 individuals, respectively. Demographic variables (age and years of education) were comparable. CHRFAM7A direct allele carriers demonstrated an upward shift in cognitive performance including cognitive processing speed, learning and memory, reaching statistical significance in visual immediate recall (FDR corrected p = 0.018). The shift in cognitive performance was associated with smaller whole brain volume (uncorrected p = 0.046) and lower connectivity by resting state functional MRI in the visual network (FDR corrected p = 0.027) accentuating the cognitive findings. These data suggest that direct allele carriers harbor a more efficient brain consistent with the cellular biology of actin cytoskeleton and synaptic gain of function. Further larger human studies of cognitive measures correlated with MRI and functional imaging are needed to decipher the impact of CHRFAM7A on brain function.

Adaptation and validation of the Greek version of the Communication and Language Assessment questionnaire for persons with Multiple Sclerosis (CLAMS).

The aim of the present study was to validate the Communication and Language Assessment questionnaire for persons with Multiple Sclerosis (CLAMS) into the Greek language. 106 Persons with Multiple Sclerosis (PwMS) and 51 healthy controls (HCs) participated in this study. We evaluated patients' cognitive abilities with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). All PwMS completed the CLAMS and three additional questionnaires (Speech Pathology-Specific Questionnaire for persons with Multiple Sclerosis, SMS; Stroke and Aphasia Quality of Life Scale-39, SAQOL-39; the Beck Depression Inventory Fast Screen, BDI-FS), and all HCs filled in the CLAMS. The internal consistency of the CLAMS was excellent (a = 0.933) for the PwMS and a significant difference was found between PwMS and HCs for the total CLAMS score. Statistical analyses showed a significant positive correlation between the CLAMS and the other questionnaires (SMS, BDI, and SAQOL-39) and a statistically significant negative correlation between the CLAMS and the three subtests of the BICAMS (Symbol Digit Modalities Test, Greek Verbal Learning Test-II, and Brief Visuospatial Memory Test-Revised). There was no correlation between the CLAMS and participants' age, disease duration, and disease type. The Greek version of the CLAMS is a valid self-reported questionnaire for the evaluation of language and communication symptoms in PwMS.

Physical Activity Moderates the Association Between Pain and Depressive Symptoms Among Persons with Multiple Sclerosis.

The present study examined physical activity as a possible moderator in the relationship between pain and depressive symptoms among persons with multiple sclerosis (PwMS). Fifty-three PwMS completed a comprehensive neuropsychological test battery and psychosocial questionnaires. Pain was operationalized as a composite of measures from the Brief Pain Inventory. Metabolic equivalents (METs) of energy expended during self-reported vigorous activity (VA), moderate activity (MA), and walking, as well as global physical activity which combined the three, were derived from the International Physical Activity Questionnaire-Short Form. Self-reported physical activity was measured using the Cognitive Health Questionnaire Exercise Scale. Regressions on depressive symptoms (Beck Depression Inventory-Fast Screen) examining both conceptualizations of physical activity, pain, and their interactions were explored. Regression analyses revealed that interactions between pain and each measure of global physical activity were significant (p = .01). Simple effects tests revealed that pain only influenced depressive symptoms in PwMS with low global physical activity METs (p < .001) and low overall self-reported physical activity (p < .001). The separate interactions between pain and METs during self-reported VA, MA, and walking on depressive symptoms were not significant. We found that global physical activity moderated the relationship between pain and depressive symptoms in MS. Specifically, pain influenced depressive symptoms in PwMS who engaged in less overall physical activity. These results highlight the importance of screening PwMS for pain and suggest that behavioral interventions aimed at increasing overall lifestyle physical activity may be useful in improving depressive outcomes in PwMS with pain.

Internet-based cognitive-behavioral therapy is effective in reducing depressive symptomatology in type 1 diabetes: results of a randomized controlled trial.

Depression in people with diabetes is associated with poorer health outcomes. Although web programs integrating cognitive-behavioral therapy with diabetes education have shown good results, no similar approach has been implemented in Spain. This aim of this study was to administer an Internet-based cognitive-behavioral therapy program (CBT) for the treatment of mild-moderate depressive symptomatology in individuals with type 1 diabetes (WEB_TDDI1 study) and evaluate the efficacy of this program. A pre-post randomized controlled study was conducted. The sample comprised 65 people with type 1 diabetes and mild-moderate depressive symptoms: 35 treatment group (TG) and 30 control group (CG). The following effects of the nine-session program were analyzed: depression (Beck Depression Inventory Fast Screen, BDI-FS), metabolic variables (glycosilated hemoglobin, HbA1c), and other psychological variables including anxiety (State Trait Anxiety Inventory, STAI), fear of hypoglycemia (Fear of Hypoglycemia Questionnaire, FH-15), distress (Diabetes Distress Questionnaire (DDS), quality of life (Diabetes Quality of Life Questionnaire, DQOL),and treatment adherence (Diabetes Self-Care Inventory-Revised questionnaire, SCI-R). At the end of the treatment program, only 28 people were evaluated (TG=8; CG=20). However, a significant reduction was found in both groups in BDI-FS and STAI-T scores, which was significantly greater in the TG. Significant improvements were also found in the TG in DQOL, FH-15, DDS and SCI-R scores. The percentage change in these variables was also statistically significant in the TG versus the CG. However, no significant results were found in HbA1c. The Internet-based cognitive-behavioral therapy program for the treatment of mild-moderate depressive symptomatology in people with type 1 diabetes (WEB_TDDI1 study) is effective in reducing depressive symptomatology in the sample that completed the study. Positive results are also produced in other variables associated with depression in this population such as diabetes-related distress, trait anxiety, fear of hypoglycemia, quality of life, and adherence to diabetes treatment. Although new studies would be necessary to support the results of this platform, the results obtained are positive and support the use of this platform as an appropriate treatment for this population. ClinicalTrials.gov; identifier NCT03473704.

41 High Stress and Negative Attributional Style is Associated with Depression Symptoms in Multiple Sclerosis

Objective:Depression is highly prevalent in persons with multiple sclerosis (pwMS). A reformulated version of the learned helplessness theory posits that individuals who attribute the cause of negative events to personal factors (internal), perceive that the cause persists for a long period of time (stable), and believe it is present in all situations (global) are at an increased risk for depression. As such, it is critical to examine possible modifiable factors that buffer against the deleterious effects of negative attributional style. Therefore, the current study investigated whether stress moderates the relationship between negative attributional style and depression symptoms in an MS sample.Participants and Methods:Thirty-six pwMS (30 Female, 6 Male) completed a comprehensive neuropsychological test battery and psychosocial questionnaires that assessed cognitive attributional style, daily stressors, and depression symptoms. The Attributional Style Questionnaire (ASQ) was used to create internal, stable, and global attribution dimension scores, as well as an overall attributional style score combining the three dimensions. Stress was quantified as the total score of perceived hassles from the Hassles and Uplifts Scale (HUS). Depression symptoms were measured using the Beck Depression Inventory-Fast Screen (BDI-FS). Hierarchical linear regressions were conducted with depression symptoms as the outcome variable. Each dimension of attributional style (internal, stable, global, or overall ASQ), stress, and their interactions were included as predictors. Simple effects tests were used to clarify the pattern of any significant interaction.Results:Regression analyses revealed that the interaction between overall attributional style and stress was significant (p = .025). Simple effects tests revealed that overall attributional style was associated with depression symptoms only in pwMS with high levels of stress (p = .015). For the individual dimensions of the ASQ, several interactions were also significant. The interaction between the internal dimension and stress was significant (p= .009), such that internal attributions were associated with depression symptoms only in pwMS with high levels of stress (p = .002). The interaction between the stable dimension and stress was also significant (p = .01); stable attributional style was associated with depression symptoms only in pwMS with high levels of stress (p = .009). The interaction between the global dimension and stress was not significant.Conclusions:Stress moderated the relationship between negative attributional style and depression symptoms in pwMS. Specifically, the internal and stable dimensions and overall attributional style were associated with increased depression symptoms only in pwMS who reported high levels of stress, but not in those with low levels of stress. Interventions aimed at reducing and managing stress may help protect against the effects of negative cognitive schemas on depression symptoms in MS. Additionally, previous research demonstrates that attributional style may be a malleable target of evidence-based psychotherapy (Seligman et al., 1988; Proudfoot et al., 2009). Our findings suggest that cognitive therapy specifically targeting the internal and stable dimensions of attributional style may be effective in modifying attributional style, perceptions of stress and, subsequently, improve depression outcomes in MS.

A - 8 Sleep Complaints Mediate the Relationship between Depression and Cognitive Performance in College Athletes.

Depression and sleep disturbance often co-occur, and both have been found to negatively impact cognitive functioning. This study aims to examine sleep as a potential mediator between depression and cognitive functioning in college athletes. 897 collegiate athletes (F = 230) completed a comprehensive neuropsychological battery including self-reported symptom measures. The Beck Depression Inventory-Fast Screen was used to measure depression, and the Post-Concussion Symptom Scale (PCSS) sleep cluster was used to quantify sleep disturbance. Depression was examined dichotomously (depressed/non-depressed). Neurocognitive functioning was examined via z-score composites of attention/processing speed (A/PS) and memory. Two mediation analyses, with depression as the independent variable, sleep disturbance as the mediator, and A/PS or memory performance as outcomes were conducted using the SPSS PROCESS macro, with 5000 bootstrap samples and 95% confidence interval. In the first mediation, depression was significantly associated with poorer A/PS performance (ß= -0.13, p = 0.02) and greater sleep disturbance (ß= 1.89, p < 0.001). Sleep disturbance was also negatively associated with A/PS performance (ß= -0.01, p = 0.03). After controlling for sleep disturbance, the relationship between depression and A/PS performance became non-significant (ß= -0.10, p = 0.08, indirect effect = -0.08, 95%CI[-0.057,-0.004]), indicating mediation via sleep disturbance. In the second mediation model, depression was not significantly associated with memory performance, so the mediation was discontinued. Sleep disturbance fully mediated the relationship between depression and A/PS performance. This suggests that sleep problems account for the relationship between depression and A/PS. Future work should examine interventions aimed at improving sleep in depressed college athletes which may translate to better academic and athletic performance through improved attention and processing speed.

A - 120 Fatigue Moderates the Relationship between Negative Attributional Style and Depression Symptoms in Multiple Sclerosis.

To investigate whether fatigue moderates the relationship between negative attributional style and depression symptoms in persons with Multiple Sclerosis (PwMS). Forty-seven PwMS (39 Female) completed a comprehensive neuropsychological test battery and psychosocial questionnaires. The Attributional Style Questionnaire was utilized to create internal, stable, and global attribution dimension scores, and an overall attributional style score combining the three dimensions. Overall, physical, psychosocial, and cognitive fatigue were measured using the Fatigue Impact Scale (FIS). The Beck Depression Inventory-Fast Screen was used to measure depression symptoms. Separate regressions with depression symptoms as the outcome were conducted with attributional style, each type of fatigue, and their interactions included as predictors. Regression analyses revealed that the interaction between attributional style and overall fatigue significantly predicted depression symptoms (p = 0.049). Simple effects tests showed that overall attributional style significantly predicted depression symptoms when overall fatigue was high (p = 0.008). The interactions between attributional style and both physical fatigue (p = 0.003) and psychosocial fatigue (p = 0.039) also significantly predicted depression symptoms. Simple effects tests showed that attributional style was associated with depression symptoms only in PwMS with high physical fatigue (p < 0.001) and high psychosocial fatigue (p = 0.018). Fatigue moderated the relationship between overall attributional style and depression symptoms in PwMS. Specifically, attributional style was only significantly associated with depression symptoms in PwMS reporting high levels of overall, physical, and psychosocial fatigue. Interventions aimed at targeting fatigue may reduce the risk that negative attributional style will lead to depressive symptoms in MS.

Depression symptoms and cognition in multiple sclerosis: Longitudinal evidence of a specific link to executive control

Background: Depression symptoms are prevalent in multiple sclerosis (MS) and associated with poorer cognition in cross-sectional studies; it is unknown whether changes in depression symptoms track with cognitive changes longitudinally. Objective: Investigate whether changes in depression symptoms correspond with cognitive changes over time in MS, and identify specific cognitive functions related to depression symptoms. Method: Persons with early relapse-onset MS (n = 165) completed a depression questionnaire (Beck Depression Inventory FastScreen) and tests of cognitive speed, executive control, and memory at baseline and 3-year follow-up. One-way ANOVAs assessed differences in cognitive change across participants with worsened, stable, or improved depression symptoms from baseline to year 3. Results: Change in depression symptoms was related to change in executive control (p = 0.001, ηp2 = 0.08; worsened mood with worsened executive control; improved mood with improved executive control), even when adjusting for cognitive speed (p = 0.002, ηp2 = 0.08). There were no links to cognitive speed (p = 0.826) or memory (p = 0.243). Regarding individual depression symptoms, executive control was related to loss of pleasure and suicidal thoughts. Conclusions: Executive control tracks with depression symptoms, raising hope that management of mood may improve executive control. The specific link between executive control and anhedonia implicates dysfunctional reward processing as a key component of MS depression.

A-54 Increased Symptoms During a Post-Concussion Neuropsychological Evaluation are Associated with Intraindividual Cognitive Variability and Anxiety

Abstract Purpose To examine the relationship between self-reported affect, cognitive functioning, and increased symptoms during a post-concussion neuropsychological evaluation. Methods 46 collegiate athletes (M=34, F=12) completed a comprehensive neuropsychological evaluation within 14 days of concussion, including measures of depression (Beck Depression Inventory-Fast Screen (BDI-FS)) and anxiety (NEO Five Factor Inventory (NEO-FFI) Anxiety Subscale). Suggested cutoffs for significant depression (BDI-FS ≥4) and anxiety (NEO-FFI Anxiety Subscale ≥10) symptomatology were utilized. The 21-item Post-Concussion Scale (PCS) was administered at the beginning (Pre-PCS) and end (Post-PCS) of testing. A difference score was calculated by subtracting Post-PCS from Pre-PCS. Composites of mean neuropsychological performance and two intraindividual variability (IIV) indices (average standard deviation and maximum discrepancy score) were created separately for two domains: memory and attention/processing speed (APS). Results Cognitive functioning explained a significant amount of the variance in Pre-Post PCS difference scores, F(6,39)=5.13, p&amp;lt;.001, R2=.44. Both IIV indices for memory and APS (all p’s&amp;lt;.02) significantly predicted difference scores, with cognitive variability increasing as Pre-Post PCS difference scores increased, but traditional mean composites did not (p’s&amp;gt;.05). Athletes who reported significant anxiety symptomatology (M=-4.33, SD=4.41) were significantly more likely than those who did not (M=.21, SD=3.75) to experience an increase in PCS symptoms, t(37)=2.66, p=.01, 95% CI [1.09,8.00]. There were no significant Pre-Post PCS symptom changes between athletes reporting significant depression symptomatology (M=.43, SD=5.19) or not (M=-.15, SD=4.61). Conclusions Higher IIV in cognitive functioning and worse anxiety symptomatology, but not traditional mean differences in cognitive functioning or depression symptomatology, were associated with an increase in symptoms during a post-concussion evaluation.

Cognitive Reserve Moderates the Effects of Fatigue and Depressive Symptoms in Multiple Sclerosis.

To investigate cognitive reserve as a possible moderator in the relationship between fatigue and depressive symptoms in persons with multiple sclerosis (PwMS). Fifty-three PwMS (37 female; mean age, 52.66; mean education, 14.81) completed comprehensive neuropsychological testing and psychosocial questionnaires assessing the perceived effects of fatigue (Fatigue Impact Scale) and depressive symptoms (Beck Depression Inventory-Fast Screen). Cognitive reserve (CR) was operationalized as Fixed CR and Malleable CR. Fixed CR was quantified as the standardized mean of years of education and a vocabulary-based estimate of premorbid intelligence. Malleable CR was quantified as the standardized mean of cognitive exertion, exercise, and socializing items from the Cognitive Health Questionnaire. Regressions on depressive symptoms examining fatigue, both conceptualizations of CR, and their interactions were explored. A Bonferroni correction was used; results were considered significant at an alpha level of p < .01. The interactions between fatigue and both conceptualizations of CR were significant, p = .005 (Fixed CR); p = .004 (Malleable CR). Simple effects tests revealed that fatigue only predicted depressive symptoms in PwMS with low Fixed CR or low Malleable CR (p's < .001), and not in those with high Fixed or high Malleable CR (p > .01). Cognitive reserve moderated the relationship between fatigue and depressive symptoms in PwMS. Specifically, fatigue does not appear to influence depression in PwMS with high cognitive reserve. Having higher cognitive reserve (either Fixed or Malleable) may reduce the likelihood that fatigue will lead to depressive symptoms in MS.

Discrepancies between self-report and objective sleep outcomes are associated with cognitive impairment and fatigue in people with multiple sclerosis and insomnia.

The primary aim of this study was to assess the degree to which discrepancies between self-reported and actigraphy-based measures of sleep are associated with specific demographic, disease characteristics, and clinical features in a sample of individuals with multiple sclerosis (MS) reporting clinically significant insomnia symptoms. Participants were 90 community-based participants with MS and insomnia. Measures included the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-Fast Screen (BDI-FS), Modified Fatigue Impact Scale (MFIS), and MS Neuropsychological Screening Questionnaire (MSNQ), and wrist actigraphy-derived sleep parameters. Discrepancy scores were calculated by subtracting actigraphy-derived values from PSQI-derived values for sleep latency (SL), total sleep time (TST), and sleep efficiency (SE). Correlations between PSQI and actigraphy-derived values were weak. Significant discrepancies, with moderate-to-large effect sizes, were observed between PSQI and actigraphy for SL, TST, and SE, whereby the PSQI yielded longer SL, shorter TST, and less SE than actigraphy. MSNQ elevations correlated with greater PSQI-actigraphy discrepancies in SL and TST. MFIS elevations correlated with greater discrepancies in TST. Discrepancies were not significantly related to BDI-FS, gender, race, education level, or MS type. Results emphasize the importance of assessing fatigue with sleep, and when feasible, inclusion of both self-report and actigraphy measures.

Depressive symptoms and affordance perception: The case of perceived reachability boundary.

According to the ecological approach to perception, affordances (i.e., action possibilities) are perceived directly in the environment and body-scaled. Previous theoretical work has suggested that the perception of action possibilities is influenced by depression (which has sometimes been conceived as an action-related disorder). However, thus far the relationship between affordance and depression has never been investigated in an experimental study. The goal of this study was to assess the relationships between reachability perception and depressive symptoms. Participants estimated their maximum ability to reach a target with their hand (without moving). Actual motor reachability capacities were then assessed. To determine the critical point, both measures were related to the participant's arm length and converted into an intrinsic body-scaled measurement. Participants were allocated to either the healthy group or the group with depressive symptoms according to their Beck Depression Inventory-Fast Screen (BDI-FS) scores. Results showed that participants with depressive symptoms were more conservative in their estimations than healthy participants. Depressive symptoms were associated with the perception of decreased motor action possibilities in comparison with what was observed when no symptoms were reported. These data are discussed in relation to theoretical models of depression and affordance.

Cholesterol pathway biomarkers are associated with neuropsychological measures in multiple sclerosis

BackgroundCognitive impairment (CI) is frequent in persons with multiple sclerosis (PwMS) and is linked to neurodegeneration. Cholesterol pathway biomarkers (CPB) are associated with blood-brain barrier breakdown, lesions, and neurodegeneration in multiple sclerosis (MS). CPB could influence CI. MethodsThis cross-sectional study (n = 163) included 74 relapsing-remitting MS (RR-MS), 48 progressive MS (P-MS) and 41 healthy control (HC) subjects. The assessed physical disability and cognitive measures were: Nine-hole Peg Test (NHPT), Timed 25-Foot Walk, Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test-3, and Beck Depression Inventory-Fast Screen. CPB panel included plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and the apolipoproteins (Apo), ApoA-I, ApoA-II, ApoB, ApoC-II and ApoE. Disability and cognitive measures were assessed as dependent variables in regression analyzes with age, sex, body mass index, years of education, HC vs. RR-MS vs. P-MS status, CPB, and a HC vs. RR-MS vs. P-MS status × CPB interaction term as predictors. ResultsSDMT was associated with the interaction terms for HDL-C (p = 0.045), ApoA-I (p = 0.032), ApoB (p = 0.032), TC/HDL-C (p = 0.013), and ApoB/ApoA-I (p = 0.008) ratios. CPB associations of SDMT were not abrogated upon adjusting for brain parenchymal volume. NHPT performance was associated with the interaction terms for TC (p = 0.047), LDL-C (p = 0.017), ApoB (p = 0.001), HDL-C (p = 0.035), ApoA-I (p = 0.032), ApoC-II (p = 0.049) and ApoE (p = 0.037), TC/HDL-C (p < 0.001), and ApoB/ApoA-I ratios (p < 0.001). ConclusionsThe LDL to HDL proportion is associated with SDMT and NHPT in MS. The findings are consistent with a potential role for CPB in CI.

Psychological Profile in Women with Chronic Pelvic Pain.

(1) Background: Chronic Pelvic Pain (CPP) is a prevalent medical condition with a complex treatment due to different variables that influence its clinical course. (2) Methods: Psychological variables such as depression, anxiety, catastrophizing or neuroticism have been described as influencing CPP. This is a cross-sectional study of 63 patients with CPP sent for a psychological evaluation due to participation in group therapy for CPP. The main purpose of this study was to characterize the baseline psychological characteristics of women with CPP. The NEO Five Factor Inventory (NEO-FFI), State and Trait Anxiety Inventory (STAI), Beck Depression Inventory-Fast Screen (BDI-FS), Pain Catastrophizing Scale (PCS) and Chronic Pain Acceptance Questionnaire (CPAQ) were performed. (3) Results: The personality profile of patients (NEO FFI) shows high neuroticism, low extraversion and low conscientiousness. The 25.4% of patients had moderate or severe depression according to BDI-FS results, almost half of the patients had high levels of anxiety trait (>P75, 49.2%) and more than half the patients had high levels of anxiety state (>P75, 59.5%). Punctuations of PCS and CPAQ are similar to patients with fibromyalgia. (4) Conclusions: CPP is associated with high levels of depression, anxiety, neuroticism, catastrophizing and low pain acceptance. It is important to develop interventions that can modify these psychological factors in order to improve the clinical course of CPP.

Feelings of loneliness, COVID-19-specific-health anxiety and depressive symptoms during the first COVID-19 wave in Swiss persons with multiple sclerosis

The aim of our study was to investigate whether self-reported feeling of loneliness (FoL) and COVID-19-specific health anxiety were associated with the presence of depressive symptoms during the first coronavirus disease 2019 (COVID-19) wave. Questionnaires of 603 persons of the Swiss Multiple Sclerosis Registry (SMSR) were cross-sectionally analyzed using descriptive and multivariable regression methods. The survey response rate was 63.9%. Depressive symptoms were assessed by the Beck Depression Inventory-Fast Screen (BDI-FS). COVID-19-specific health anxiety and FoL were measured using two 5-item Likert scaled pertinent questions. High scoring FoL (2.52, 95% confidence interval (CI) (2.06—2.98)) and/or COVID-19 specific health anxiety (1.36, 95% CI (0.87–1.85)) were significantly associated with depressive symptoms. Further stratification analysis showed that the impact of FoL on depressive symptoms affected all age groups. However, it was more pronounced in younger PwMS, whereas an impact of COVID-19 specific health anxiety on depressive symptoms was particularly observed in middle-aged PwMS. FoL and COVID-19-specific health anxiety were age-dependently associated with depressive symptoms during the first COVID-19 wave in Switzerland. Our findings could guide physicians, health authorities, and self-help groups to better accompany PwMS in times of public health crises.

A-12 Physical Activity Attenuates the Effect of Pain on Depression Symptoms in Multiple Sclerosis

Abstract Objective: This study examined physical activity as a potential moderator of the relationship between pain and depression symptoms in persons with multiple sclerosis (PwMS). We hypothesized that pain would predict depression symptoms only in PwMS with low physical activity. Method: Fifty-four PwMS (38 female) completed a comprehensive neuropsychological test battery and questionnaires. Pain was operationalized as a composite of measures from the Brief Pain Inventory (BPI). The metabolic equivalents (METs) of energy expended during vigorous activity (VA), moderate activity (MA), and walking, as well as global activity which combined the three, were derived from the International Physical Activity Questionnaire-Short Form (IPAQ-SF) based on parameters previously used by Dlugonski et al. (2011). Lower METs suggest less physical activity. The Beck Depression Inventory-Fast Screen (BDI-FS) was used to measure depression symptoms. Linear regressions on depression examining pain, each physical activity index, and their interactions were explored. Results: Regression analyses showed that the interaction between pain and global MET significantly predicted depression (p = 0.01). Simple effects tests revealed that pain predicted depression symptoms only in PwMS with low MET scores (p &amp;lt; 0.001). The separate interactions between pain and VA, MA, and walking predicting depression symptoms were not significant. Conclusion: We found that global physical activity moderated the relationship between pain and depression in MS. Specifically, pain predicted depression symptoms in PwMS who engaged in less physical activity. These results highlight the importance of screening PwMS for pain and suggest that interventions aimed at increasing overall physical activity may be useful in improving depression outcomes in PwMS with pain.

Comparison of spouse and patient personality change judgments following MS onset

ABSTRACT Objectives This is the first study to estimate the prevalence and predictors of spouse and patient perceptions of global/overall personality change (PC) in patients with multiple sclerosis (MS). Methods 69 clinic patients and their spouses completed parallel measures of perceived PC and semantic differential scales measuring pre-MS and current specific behaviours. We correlated perceived personality changes with the following measures of perceived physical, cognitive, emotional, and social functioning: MS Impact Scale, MS Neuropsychological Questionnaire, Beck Depression Inventory-FastScreen; Hospital Anxiety and Depression Scale; Family Questionnaire, McMaster Assessment Device; and Social Provisions Scale. Results Spouses and patients reported comparable levels of substantial change. Both associated PC with patient distress, perceived cognitive impairment, spouse distress, and poorer family functioning. Spouse, but not patient, PC ratings predicted severity of physical symptoms and social support. Principal component analysis of semantic differential ratings yielded a Compassionate Empathy component correlating with PC within spouse, but not patient, data. Conclusions These partially overlapping potential triggers for spouse and patient PC judgments raise questions about the extent they overlap with clinicians’ criteria for PC, since spouses did not link impulsivity with PC. It is also suggested that the initial focus of treatment of PC should focus on partner-agreed changes.

Coping Style Moderates the Effect of Pain on Depression Symptoms in Multiple Sclerosis.

The present study examined coping style as a possible moderator in the relationship between pain and depression in persons with multiple sclerosis (PwMS). Fifty-four PwMS completed a comprehensive neuropsychological test battery and psychosocial questionnaires that assessed physical, cognitive, and emotional functioning. Using four pain indices (i.e., average pain, current pain, pain intensity, and pain interference) from the Brief Pain Inventory (BPI), an overall pain index was created to capture a more comprehensive index of individuals' overall pain intensity and interference. The COPE questionnaire was used to derive three coping indices: active coping, avoidant coping, and a composite cope index that accounts for the relative contributions of both active and avoidant coping. The Beck Depression Inventory-Fast Screen (BDI-FS) was used to measure depressive symptomatology. A series of hierarchical linear regressions were conducted with depressive symptoms as the outcome variable. Regression analyses revealed that the interactions between overall pain and each conceptualization of coping were significant (p = .001-.003). Simple effects tests revealed that overall pain only predicted depressive symptoms in PwMS with low active coping (p < .001), high avoidant coping (p < .001), and less adaptive coping via the composite coping index (p < .001). We found that pain predicted depressive symptoms in PwMS who utilized more avoidant and less active coping strategies. Interventions aimed to improve coping style may be effective in enhancing the ability to manage pain and, subsequently, improve depression outcomes in MS.