The determinants of depression in a Romanian cohort of multiple sclerosis patients

The aim of the present study was to assess the prevalence of depression in a large multiple sclerosis (MS) patient group and to analyse the physical and psycho-socio-economic factors that influence its frequency and severity. In total, 351 consecutive patients with a diagnosis of MS were included in this study. All the patients completed a survey about their demographic characteristics, marital status, presence of children, employment status, educational level, duration of disease, disease course, duration of treatment and type of disease modifying therapies (DMT). Their disability level was evaluated using the Expanded Disability Status Scale (EDSS). Their depression level was evaluated using the Romanian Version (2012) of the Beck Depression Inventory-II (BDI-II). There was a significant positive correlation between the BDI-II score and the actual age of the patients, their disease duration, EDSS and the number of total relapses. From the EDSS functional scores, only the pyramidal score and the sensitive score presented a significant association with BDI-II in the logistic regression analysis. The BDI-II values decreased significantly with increasing education level. In the case of the retired patients, the BDI-II values were significantly higher. The BDI-II scores were also higher in widowers and divorced patients and in patients with children. There was no significant difference in the BDI-II values between different DMT groups. The main physical and psycho-socio-economic determinants of depression in patients with MS are the physical disability, disease duration, number of relapses, marital status, education level, employment status, and the presence of children, but many unsolved questions remain about the interrelations and relative contributions of these factors, which necessitates further research. The DMTs did not significantly influence the depression level.