Beck Depression Inventory-Fast Screen Research Articles

Prevalence and relationship between burnout and depression in our future doctors: a cross-sectional study in a cohort of preclinical and clinical medical students in Ireland

ObjectivesThis cross-sectional study was designed to measure burnout and its impact on risk of depression in a medical student population, comparing the preclinical and clinical years.DesignWe conducted a survey of...

Frontal lobe dysfunction as a predictor of depression and anxiety following temporal lobe epilepsy surgery

ObjectivePredictors of psychiatric outcome following TLE surgery have proved elusive and represent a current challenge in the practice of TLE surgery. This prospective study investigated whether frontal lobe dysfunction is predictive of poorer psychiatric outcomes. MethodsForty-nine unilateral TLE surgical patients were assessed using the Beck Depression Inventory–Fast Screen (BDI-FS) and Beck Anxiety Inventory (BAI) preoperatively and 6 and 12 months postoperatively. Measures of intellectual function, semantic knowledge, memory and executive function were completed preoperatively, at 6 and 12 months following surgery. ResultsPreoperatively, 33 (67%) patients had minimal depressive symptoms, 8 (16%) were mildly depressed, 2 (4%) were moderately depressed, and 6 (12%) reported severe depressive morbidity. Twenty-three (47%) patients reported minimal anxiety, 18 (37%) were mildly anxious, 6 (12%) were moderately anxious and 2 (4%) patients reported severe anxiety symptoms. A mixed-model repeated-measures analysis was performed on the BDI-FS and BAI scores, adjusting for pertinent covariates identified in univariable analyses. At a year following TLE surgery, anxiety symptoms significantly improved but depressive morbidity did not. Indicators of frontal lobe dysfunction moderated the magnitude and direction of mood change. Specifically, pre-surgical cognitive measures of frontal lobe dysfunction predicted increased depression and anxiety symptoms following surgery. There was no relationship between preoperative BDI-FS or BAI scores and seizure outcome at 12 months or change in affective morbidity and seizure outcome. SignificanceThis is the first longitudinal study to provide evidence that specific pre-surgical cognitive and behavioural indices of frontal dysfunction are predictive of poorer psychiatric outcome following TLE surgery. In addition, our findings highlight the potential utility of a dysexecutive behavioural rating scale (DEX) as an assessment tool in epilepsy. Examination of executive functioning in pre-surgical evaluations may lead to an increase in the power of prognostic models used to predict the psychiatric outcome of TLE surgery.

Clinical course of depression symptoms and predictors of enduring depression risk in women with polycystic ovary syndrome: Results of a longitudinal study

To [1] characterize depression symptoms over time and [2] test the hypothesis that adverse metabolic parameters would associate with risk of enduring depression risk in women with polycystic ovary syndrome (PCOS). Prospective cohort study. University center. One hundred sixty-three women with PCOS. The Beck Depression Inventory Fast Screen (BDI-FS) was self-administered at baseline and follow-up to identify depression risk, using a cutoff score >4. BDI-FS scores. Median baseline age was 29.0years, and median follow-up interval was 5.5years. Fifty-nine of 163 women had positive depression screens at baseline (36%); 52 women (32%) screened positive at follow-up. Median change in BDI-II score was 0 (interquartile range, -2, 1) over the study period. Of the 59 women at risk for depression at baseline, 22 screened negative at follow-up (37%), while 37 women remained at risk (63%). Considering these 59 women with positive depression screens at baseline, higher body mass index (BMI) was associated with increased odds of enduring depression risk at follow-up (adjusted odds ratio = 1.09; 95% confidence interval, 1.00, 1.18), in a multivariate logistic regression model. Compared with women with normal body weight at baseline, obese women (BMI >30kg/m2) had five-fold increased odds of enduring depression risk at follow-up (adjusted odds ratio = 5.07; 95% confidence interval, 1.07, 24.0). The prevalence of depression was relatively stable over time in a cohort of women with PCOS. Elevated BMI is a hallmark of enduring depression risk. These results may assist providers in developing targeted intervention strategies to reduce the prevalence of long-term depressive symptoms in women with PCOS.

Validity of the ImPACT Post-Concussion Symptom Scale (PCSS) Affective Symptom Cluster as a Screener for Depression in Collegiate Athletes.

The relationship between depression and sports-related concussion is complex and has implications both pre- and post-injury. The current study established the construct validity, convergent and discriminant, of the affective symptom cluster of The Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) post-concussion symptom scale (PCSS) as a screening tool for depression. Nine hundred and thirty (M = 695, F = 235) college athletes were assessed at baseline using the ImPACT PCSS and Beck-Depression Inventory-Fast Screen (BDI-FS). Previous factor analysis identified four symptom clusters on the PCSS: affective, physical, cognitive, and sleep. Clinically significant depression was operationalized as a BDI-FS score ≥4. Receiver Operating Characteristic curves (ROC) were used to determine the ideal cutoff, Chi-square tests of independence were calculated to establish convergent validity, and Fisher's r-to-z comparisons were used to establish discriminant validity of the affective symptom cluster. The 90th percentile cutoff yielded the highest sensitivity and specificity on the affective symptom cluster for males (4) and females (6). The correlation between BDI-FS and the 90th percentile cutoff was statistically significantly higher in females (φ = .96) than males (φ = .83), Z = 9.49, p < .001. When correlating the BDI-FS with each PCSS symptom cluster, the correlation with the affective symptom cluster was stronger than its correlation with cognitive, sleep, and physical clusters across gender. By utilizing a measure of depression within an existing and commonly used assessment, clinicians can easily screen for depression and identify athletes at risk for complicated recovery even in the absence of a supplemental depression assessment.

Enduring depression in polycystic ovary syndrome: results of a longitudinal study

Cross-sectional data reveal an increased prevalence of depressive symptoms in women with polycystic ovary syndrome (PCOS). The trajectory of symptoms over time has not been described due to a lack of longitudinal studies. We sought to describe the course of depressive symptoms over time and to identify predictors of enduring depression risk in PCOS using a longitudinal design. Longitudinal cohort study Rigorously characterized women with PCOS-Rotterdam ages 16-44 were enrolled in a cohort study between 2006 and 2017 following a visit to a multi-disciplinary clinic. The Beck Depression Inventory Fast Screen (BDI-FS) was self-administered to identify depression risk using a cut-off score of >4 at the baseline visit. A follow-up survey was distributed via email in 2017 to determine interval changes and the BDI-FS was repeated. Women with positive depression risk at baseline were divided into two groups on the basis of whether they screened positive or negative for depression risk at follow-up. Kruskall-Wallis, chi-square and Fischer’s exact testing compared parameters between groups. Multivariate logistic regression modeling evaluated factors associated with odds of enduring depression during the study period. A 42% response rate (179/423) yielded 163 women with complete BDI-FS data at baseline and follow-up. At baseline, median age was 29.0 years (IQR 25.2, 32.2) and BMI was 28.3 kg/m2 (IQR 24.1, 35.2). Follow-up interval was 5.5 years (IQR 2.4, 8.1). 59/163 women screened positive for depression risk at baseline (36%); 52 women (32%) screened positive at follow-up. Median change in BDI-II score was 0 (IQR -2, 1) over the study period. Of the 59 women with depression risk at baseline, 37% were not depressed at follow-up (Resolved group), while 63% had enduring depressive symptoms (Enduring group). For subjects with depression risk at baseline, participants with enduring depression had higher total and LDL cholesterol, lower HDL and a trend toward higher BMI at baseline compared to subjects with resolved depression risk. Serum androgens and hirsutism scores did not differ between groups. In a multivariate logistic regression model controlling for baseline age, baseline BDI-FS score and follow-up interval, each additional unit of BMI at baseline increased odds of enduring depression by 9% (aOR 1.09, 95% CI 1.00, 1.18, p=0.05). Similarly, compared to women with normal body weight, women in the obese range at baseline (BMI >30 kg/m2) had a five-fold increased risk of enduring depression at follow-up (aOR 4.81, 95% CI 0.94, 24.6, p=0.058). Women with PCOS are at high risk of mood disorders. We found that the prevalence of depression was relatively stable over time in a cohort of women followed longitudinally, and that elevated BMI is a hallmark of enduring depression risk. These results may assist providers in developing targeted intervention strategies to reduce the prevalence of women with long-term depressive symptoms.

Cognitive Reserve Attenuates the Effect of Disability on Depression in Multiple Sclerosis.

The current study explored the moderating role of cognitive reserve on the relationship between disability and depression in a sample of individuals in which brain pathology is thought to contribute to depression (multiple sclerosis; MS). Fifty-four individuals with MS were examined. Depression was measured using the Beck Depression Inventory-Fast Screen (BDI-FS). In addition to collecting demographic (education) and disease burden (Expanded Disability Status Scale; EDSS) related variables, participants completed a neuropsychological test battery and psychosocial questionnaires. Cognitive reserve (CR) was conceptualized in two ways: Fixed CR and Malleable CR. Fixed CR was measured using years of education and crystallized intelligence (Shipley Vocabulary). Malleable CR was operationalized as a composite of measures from the Cognitive Heath Questionnaire (CHQ). Two regressions on depression (BDI-FS) examining either type of cognitive reserve, EDSS, and their interactions were explored. Results: The interaction between EDSS and both conceptualizations of cognitive reserve were significant, t(50) = -2.60, p = .013, PRE = .12 (Fixed CR); t(47) = -2.02, p = .049, PRE = .08 (Malleable CR). Simple effects testing revealed the same pattern regardless of the type of cognitive reserve examined; EDSS predicted depression only in those with low cognitive reserve. Cognitive reserve moderates the relationship between disability and depression in MS; disability does not appear to influence depression in those with high cognitive reserve.

Perceived personality change after traumatic brain injury II: comparing participant and informant perspectives

ABSTRACTObjective: The objective of this paper was to correlate informant personality change (PC) judgements following moderate–severe traumatic brain injury with quantitative neurobehavioural measures and to contrast the neurobehavioural correlates of informant and participant judgements of PC.Participants: Informant–participant pairs were recruited from a medico-legal clinic passing effort tests (N = 31) and a National Health Service clinic (N = 40).Measures: Participants were assessed on Wechsler tests of general ability, tests of executive functioning (Zoo Map and Fluency) and emotional distress (Beck Depression Inventory-FastScreen, Hospital Anxiety and Depression Scale and State-Trait Anger Expression Inventory-II). Informants’ expressed emotion towards participants was assessed with the family questionnaire. Both completed the DEX, the Frontal and Social Behavior Questionnaire and PC ratings.Results: The correlates of participant and informant ratings of participant PC partially overlapped. For example, participant self-reported PC was associated with self-reported dysexecutive symptoms and emotional distress. In contrast, informant report of participant PC was associated with lower perceived emotional recognition and empathy, informant report of dysexecutive symptoms and high informant expressed emotion.Conclusions: It is argued that whilst researchers aim to exhaustively quantify specific neurobehavioural changes and their clusters, partially overlapping subsets of these changes evoke the PC judgements of participants and informants. The clinical implications of this are briefly considered.

Comparison of four brief depression screening instruments in ovarian cancer patients: Diagnostic accuracy using traditional versus alternative cutpoints

ObjectivesWe compared the diagnostic accuracy of 4 depression screening scales, using traditional and alternative scoring methods, to the gold standard Structured Clinical Interview-DSM IV major depressive episode (MDE) in ovarian cancer patients on active treatment. MethodsAt the beginning of a new chemotherapy regimen, ovarian cancer patients completed the following surveys on the same day: the Center for Epidemiological Studies Depression Scale (CES-D), the Beck Depression Inventory Fast-Screen for Primary Care (BDI-FastScreen), the Patient Health Questionnaire-9 (PHQ-9), and a 1-item screener (“Are you depressed?”). Each instrument's sensitivity, specificity, positive predictive value (PPV) and negative predictive value were calculated with respect to major depression. To control for antidepressant use, the analyses were re-run for a subsample of patients who were not on antidepressants. ResultsOne hundred fifty-three ovarian cancer patients were enrolled into the study. Only fourteen participants met SCID criteria for current MDE (9%). When evaluating all patients regardless of whether they were already being treated with antidepressants, the two-phase scoring approach with an alternate cutpoint of 6 on the PHQ-9 had the best positive predictive value (PPV=32%). Using a traditional cutpoint of 16 on the CES-D resulted in the lowest PPV (5%); using a more stringent cutpoint of 22 resulted in a slightly improved but still poor PPV, 7%. ConclusionsScreening with a two-phase PHQ-9 proved best overall, and its accuracy was improved when used with patients who were not already being treated with antidepressants.

Validation de la traduction française d’un questionnaire court de dépression de Beck (BDI-FS-Fr)

IntroductionDepression is a public health problem and constitutes the most frequently psychic manifestation observed among students. Its prevalence is much higher (30%) than in the other populations. Depression among students can have negative impacts on their social, relational situation and significantly impact their quality of life. Depression is misdiagnosed, misdetected and thus mistreated. In clinical practice at the University, the clinician finds difficulty in correctly diagnosing depression comorbidity including depression with a physical illness and/or somatic problems. It underestimates or overestimates depression (false negative diagnosis or false positive diagnosis). The difficulties of diagnosing depression and overlap with the physical symptoms of the disease are the challenges for the clinician to differentiate if certain symptoms are related to depression or physical illness. Thus, the difficulty in detecting and/or diagnosing depression can lead to false diagnoses of depression. So to avoid the false diagnosis of depression in the university context or in the disease, we must take into account the cognitions of depression. The BDI-FS, self-assessment scale to detect depression, considers these cognitions and therefore avoids the false diagnosis of depression in the presence of problems (such as a physical illness or somatic problems) and properly detects the depression. ObjectiveThis article presents the French validation of the Beck Depression Inventory-Fast Screen (BDI-FS Inventory) on a sample of students. MethodA cross-sectional study was conducted on 473 students of the University of Caen Normandy. ResultsThe Beck Depression Inventory-Fast Screen-France (BDI-FS-Fr) gets a good sensitivity, specificity and good positive and negative predictive value, a coefficient of Yule very strong and area under the curve satisfactory. He has a very good internal validity of structure: an exploratory factor analysis identified a factor that explains 40.21% of the total variance of the BDI-FS-Fr, and he has a satisfactory internal consistency (0.74). The BDI-FS-Fr has a very good external validity of structure (construct validity: convergent and divergent validity; P<0.001) and discriminate validity (P<0.001), and concurrent validity (P<0.001). The split-half reliability (odd-even) was 0.73 (P<0.001). The test-retest reliability was 0.82 (P<0.001). Regarding clinical practice in the University, clinicians can use a simple questionnaire include 7 items (Beck Depression Inventory-Fast Screen-French: BDI-FS-Fr) to assess depression avoiding false diagnosis of depression in the University. The BDI-FS-Fr only evaluates the non-somatic symptoms (cognitive) rather than physical symptoms (somatic), which may overlap with problems due to the university or physical illness and depression may overlap. The BDI-FS-Fr only includes items the BDI-II that are related to the direct psychological experience of depression. Thus, the key strength of the BDI-FS-Fr is that it prevents symptoms of physical illness (e.g., weight loss, difficulty concentrating) from confounding the psychodiagnostic picture. The BDI-FS-Fr also allows us to evaluate the two diagnoses DSM-IV-TR (the main symptoms of depression: sadness and anhedonia). It also allows us to observe and assess the risk of suicide in people (ex. students and patients) by observing the items 2 (pessimism) and 7 (thoughts or desires of suicide) that are considered suicidal risk indicators. The BDI-FS is a diagnostic tool that minimizes the risk of giving falsely high estimates of depression in subjects focusing on the cognitive symptoms of depression. For pre-cited reasons, the clinicians can use the BDI-FS-Fr among students to diagnose their depression and assess their risk for suicide without false negative or false positive diagnosis. ConclusionThe French version of the BDI-FS has very favourable psychometric properties. It is valid for self-assess depression, its intensity and its evolution, and it is a good complement to BDI for students. The BDI-FS-Fr thus has very good psychometric properties and is a useful tool for researchers and practitioners.

Beyond binary: Exploring the merits of three depression groups in multiple sclerosis.

Depression has been traditionally explored in the context of multiple sclerosis (MS) as a binary construct (depressed, not depressed). However, given the 50% lifetime prevalence rate of depression in MS, it may be useful to consider not only currently depressed versus nondepressed patients, but to evaluate groups that better characterize the complexity of MS depression. The objective of the current study was to examine demographic, cognitive, illness, and psychosocial variables thought to associate with depression in MS across 3 groups: currently depressed, remitted depression, and never been depressed. Fifty-four individuals with MS were examined. Current depression status was measured using the Beck Depression Inventory-Fast Screen (BDI-FS; Beck, Steer, & Brown, 2000). Past depression was evaluated using the Structured Clinical Interview for DSM-IV Disorders (SCID-IV; First, Spitzer, Gibbon, & Williams, 1998) and a semistructured psychosocial interview. The results of the current study show that evaluating depression in 3 groups is useful for exploring risk, protective, and compensatory factors of depression in MS. A consistent grouping pattern (e.g., the remitted depression group always functioning the same as the never been depressed group) was not found among the variables examined; rather, several different patterns were observed. Several of these patterns revealed differences between the remitted depression and never been depressed groups; these differences would not have been observed had these 2 groups been combined into a "not currently depressed" group. These different patterns yield important information about the complex relationships of depression in MS that may be obscured when depression is viewed as a binary construct. (PsycINFO Database Record

Relationship between immune biomarkers and both physical activity and stress levels in young and older adults

Physical activity promotes a healthy immune system which may be of particular importance for older adults since immunosenescence is a major concern for this population. In this study we investigated differences in physical activity levels, stress levels, and immune biomarkers in young versus elderly participants. We then looked for associations between physical activity and stress with immune biomarkers. 19 young adults (18–45 yrs) and 19 gender-, race-, and BMI-matched elderly adults (>60 yrs) completed the International Physical Activity Questionnaire (IPAQ), the Perceived Stress Scale (PSS), the Beck Depression Inventory Fast Screen (BDI-FS), and the State Trait Anxiety Inventory (STAI-S/T), and donated blood for assessment of CD4+ T cell biomarkers. The elderly group had significantly lower scores on the PSS, BDI-FS, STAIS, and STAIT; had a tendency to engage in more hours of moderate physical activities each week; and had a significantly higher Tr1 and a significantly lower Th3 compared to the young group. Age significantly moderated the relationship between physical activity and both Tr1 cells and IFNgamma production. For the stress measures, age significantly moderated the relationship between Th3 cells and depression. These data show that immune biomarkers in elderly people may be affected differently by exercise and stress compared to young people.

Depression and hypomania symptoms are associated with high dose corticosteroids treatment for MS relapses

BackgroundPsychiatric side effects are known to occur with low dose corticosteroids. Standard of care for Multiple Sclerosis (MS) relapses is high dose corticosteroids (HDC), at least 1g/day for 3–5 days, and yet the relationship between this treatment and mood is not known. We sought to determine the frequency and potential predictors of (hypo)manic and depressive symptoms with HDC treatment for MS relapses. MethodsConsecutive MS subjects requiring HDC treatment were identified. The Mood Disorders Questionnaire (MDQ) and the Beck Depression Inventory-Fast Screen (BDIFS) were administered for (hypo)manic and depressive symptoms, respectively, prior to HDC, 3 days and one month post-HDC. ResultsEighty eight subjects completed the study. At relapse diagnosis, the mean BDIFS score was 4.2 (SD 3.1); the mean number of (hypo)manic symptoms endorsed on the MDQ was 4.3 (SD 3.5). Three days after completing HDC, 22.5% had an increase on the BDIFS and 38.2% endorsed more symptoms on the MDQ. A history of depression (p=0.006) and low reported quality of life (p=0.029) predicted an increase on the MDQ; the odds of an increase in (hypo)manic symptoms was 5.6 times higher with a history of any psychiatric disease/substance abuse (p=0.005). No predictors for worsening on the BDIFS were found. LimitationsSelf-reported measures were used, anxiety was not evaluated and 17 subjects were lost to follow up. ConclusionDepressive and hypo(manic) symptoms are commonly associated with HDC for MS relapses. It is important for clinicians and MS patients to be aware of this risk.

PREDICTING PSYCHIATRIC OUTCOME FOLLOWING TEMPORAL LOBE EPILEPSY SURGERY: A LONGITUDINAL STUDY

ObjectiveNeurosurgery is an effective therapy for selected individuals with medically refractory temporal lobe epilepsy (TLE). Following TLE surgery, however, affective symptoms (depression/anxiety) can worsen or develop for the first time...

Depression in multiple sclerosis: The utility of common self-report instruments and development of a disease-specific measure

The ultimate objective of the present investigation was to improve the detection of depression in multiple sclerosis (MS) by comparing common self-report depression measures to a new, modified measure, which takes into account the contribution that symptoms of MS may have on individuals’ reports. There has been a longstanding concern regarding the accurate assessment of depression in MS, particularly with regard to the overlap of MS symptomatology and neurovegetative depression symptoms on self-report questionnaires, which may lead to an overdiagnosis of depression in MS. To address these difficulties, we previously proposed a “trunk and branch” of depression in MS. This model allows for the delineation of what symptoms are most reflective of depression in MS. By identifying these symptoms, it was possible to develop a modified Beck Depression Inventory (BDI) in which only the items found to be most related to depression in MS are included in the new measure, the MS Specific BDI (MS-BDI). We compared this measure to common self-report instruments (Beck Depression Inventory–Second Edition, BDI–II; Beck Depression Inventory–Fast Screen, BDI–FS; Chicago Multiscale Depression Inventory, CMDI). Results suggest that cutoffs of 4 on the BDI–FS and 23 on the CMDI Mood subscale are most useful when screening for depression in MS, with a sensitivity for both of 100%, while a cutoff of 19 on the BDI–II, a cutoff of 22 on the CMDI Evaluative scale, and a cutoff of 8 on the MS-BDI had high specificities, suggesting they can be used as to assist in diagnosing depression in MS.

Sad and Worried Hearts: A Psychological Treatment for Clinically Significant Depression, Anxiety, and Post-traumatic Stress in Patients with Cardiac Disease

People who suffer from depression, post-traumatic stress, or anxiety following cardiac events and treatment are more likely to have further cardiac complications resulting in death than are people who do not. Although there have been advances in psychological techniques to elicit behavior and lifestyle changes in heart patients [1], there is currently a dearth of information on how to address the psychological sequelae of heart disease effectively. The goals of this pilot study were therefore to develop and test a cognitive-behavioral psychological treatment that was specifically tailored to the needs of people with cardiac disease and symptoms of psychological distress. Fifteen men and 12 women between the ages of 35 and 85 who exhibited clinically significant symptoms of depression, anxiety, or post-traumatic stress following a diagnosis of heart disease participated in a maximum of 20 sessions of cognitive-behavioral therapy. By the end of treatment, there were statistically significant reductions in all symptoms of psychological distress, as measured by the Beck Depression Inventory Fast Screen for Medical Patients [2], the Beck Anxiety Inventory [3], the Hospital Anxiety and Depression Scale [4], and the Impact of Event Scale, Revised [5]. We present the treatment protocol in detail and discuss our results in terms of the utility of the integration of psychological services into cardiac care.

Putative role for insulin resistance in depression risk in polycystic ovary syndrome

To evaluate whether insulin resistance is associated with depression risk in women with polycystic ovary syndrome (PCOS), independent of other factors, including body mass index (BMI). Cross-sectional. Tertiary university center. A total of 301 women, aged 14-52 years, with PCOS by Rotterdam criteria, consecutively examined between 2006 and 2013. Complete history and physical examinations, including endovaginal ultrasounds, dermatologic assessments, completion of Beck Depression Inventory Fast Screen (BDI-FS), and serum testing. Scores >4 on BDI-FS indicated a positive screen for depression. Scores were further subdivided into mild (5-8), moderate (9-12), and severe (>12) depression risk. Insulin resistance was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). A total of 131 women (44%) were at risk for depression, determined by positive BDI-FS screening. These patients had higher BMI (32.3 vs. 28.5), and elevated insulin resistance, assessed by HOMA-IR (5.2 vs. 2.6), compared with patients with negative depression screening. In a stratified analysis by BMI category, obese women with positive depression screens had elevated HOMA-IR, compared with obese women with normal BDI-FS scores (7.4 vs. 4.1). In a multivariate logistic regression analysis, HOMA-IR was independently related to the odds of depression risk after controlling for age, ethnicity, BMI, and exercise (odds ratio: 1.07). Depression is common in PCOS. After controlling for confounders in multivariate regression analyses, we found HOMA-IR to be significantly associated with depression risk. Our data suggest a complex interplay among insulin resistance, obesity, and depression in PCOS, warranting additional investigation. Mental health assessment is indicated in comprehensive care of patients with PCOS.

The effect of executive function on stress, depression, anxiety, and quality of life in multiple sclerosis

The experience of cognitive deficits and emotional dysfunction are prevalent in people with multiple sclerosis (PwMS), although research examining their interaction has provided inconsistent findings. The current study examined the ability of executive function to predict psychosocial adjustment in PwMS. One hundred and seven PwMS underwent cognitive assessment and completed measures of stress, depression, anxiety, and quality of life (QoL). There was limited support for a relationship. There was no relationship between objective cognitive tasks and state or trait anxiety, mental health QoL, overall QoL, or stress frequency. The only relationship with depression was found when the Beck Depression Inventory Fast-Screen was used, with a task of planning when the timing element was removed. A measure of error rates on a task of cognitive flexibility predicted physical health QoL, and severity, but not frequency, of stress was predicted by a task of working memory. The results of this study highlight the need for further research into the relationship between cognitive deficits and psychosocial adjustment because of the conflicting findings between studies and call for a common measurement framework for future investigation.

Predictors and prevalence of postconcussion depression symptoms in collegiate athletes.

Depression is common after concussion and is associated with functional outcome and quality of life after injury. However, few baseline predictors of postconcussion depressive symptoms (PCDS) have been found. To describe the prevalence of depressive symptoms in a collegiate athlete sample at baseline and postconcussion, compare these levels of symptoms and change in symptoms with those of a control group with no reported concussions in the past year, and examine the baseline predictors for PCDS. Case-control study. Undergraduate institution. Participants were 84 collegiate athletes (65 men, 19 women) with concussion and 42 individuals (23 men, 21 women) with no history of recent concussion who served as controls. The Beck Depression Inventory-Fast Screen was administered to the concussion group at baseline and postconcussion and to the control group at 2 time points. Seventeen athletes (20%) showed a reliable increase in depression, and more athletes reported clinically important depression postconcussion than at baseline. Only 2 participants (5%) in the control group showed a reliable increase in depression. Concussed athletes were more likely to show a reliable increase in depression symptoms than control participants (χ(2)1 = 5.2, P = .02). We also found several predictors of PCDS in the athletes, including baseline depression symptoms (r = 0.37, P < .001), baseline postconcussion symptoms (r = 0.25, P = .03), estimated premorbid intelligence (full-scale IQ; r = -0.29, P = .009), and age of first participation in organized sport (r = 0.34, P = .002). For the control group, predictors of depression symptoms at time 2 were number of previous head injuries (r = 0.31, P = .05) and baseline depression symptoms (r = 0.80, P < .001). A large proportion of athletes showed a reliable increase in depression after concussion, and we identified several baseline predictors. Given that depression affects quality of life and recovery from concussion, more research is necessary to better understand why certain athletes show an increase in PCDS and how these can be better predicted and prevented.

Perceived cognitive difficulties and cognitive test performance as predictors of employment outcomes in people with multiple sclerosis.

Perceived cognitive difficulties and cognitive impairment are important determinants of employment in people with multiple sclerosis (pwMS). However, it is not clear how they are related to adverse work outcomes and whether the relationship is influenced by depressive symptoms. Thus, this study examined perceived and actual general cognitive and prospective memory function, and cognitive appraisal accuracy, in relation to adverse work outcomes. The possible mediating and/or moderating role of depression was also examined. A cross-sectional community-based sample of 111 participants (33 males, 78 females) completed the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), Beck Depression Inventory - Fast Screen (BDI-FS), and questions related to their current or past employment. They then underwent cognitive testing using the Screening Examination for Cognitive Impairment, Auditory Consonant Trigrams test, Zoo Map Test, and Cambridge Prospective Memory Test. Perceived general cognitive and prospective memory difficulties in the workplace and performance on the respective cognitive tests were found to predict unemployment and reduced work hours since MS diagnosis due to MS. Depression was also related to reduced work hours, but it did not explain the relationship between perceived cognitive difficulties and the work outcomes. Nor was it related to cognitive test performance. The results highlight a need to address the perceptions of cognitive difficulties together with cognitive impairment and levels of depression in vocational rehabilitation programs in pwMS.

Screening for Depression in Adult Patients with Multiple Sclerosis

Major depression and suicide are high among patients with MS. Despite the high prevalence of depression among persons with MS, only half of patients are screened and depression often remains undetected. Objective: To determine the correlation between the Beck Depression inventory-II (BDI-II) and the Beck Depression Inventory Fast Screen (BDI-FS), and to determine if the degree of disability as measured by the Expanded Disability Status Scale (EDSS) and the number of MS relapses were correlated with depression as measured by the BDI-II, and the BDI-FS. Methods: A sample of 34 persons with MS was selected from an urban neurological outpatient clinic in the Northeast United States. Descriptive, Chi-Square and Pearson correlations were used to analyze the data. Results: The sample was primarily female (71%), Caucasian (73.5%), married (56%), educated (67%), and lived with a partner or their family (68%). There was a significant positive correlation between the BDI-II and BDI-FS (r =0.82, p=0.01). The BDI-FS identified significantly more depressed persons than the BDI-II (X2=22.61, df=1, p< 0.001). There was no correlation between the extent of disability or number of MS relapses and depression as measured by either the BDI-II or BDI-FS. Conclusions: The study supports the ability of both tools to identify depressive symptoms among individuals with MS. The BDI-FS may be more efficient in identifying depression in the clinical setting among MS patients since it contains no items that assess symptoms commonly associated with MS.