Multiple Sclerosis Patients in Saudi Arabia: Prevalence of Depression and its Extent of Severity

Abstract

Introduction and Background: Multiple sclerosis (MS) is a serious chronic autoimmune disorder of the central nervous system of unknown etiology. MS-related depression is a common mood disorder recognized within the medical community. However, their association is ambiguous, underdiagnosed, undertreated and widely less reported. The study aimed to estimate the point prevalence and severity of depression among multiple sclerosis patients in Saudi Arabia. Methods: We conducted an observational cross-sectional study among multiple sclerosis patients in Riyadh region, Saudi Arabia. Patients filled demographic data and Patient Health Questionnaire-9 (PHQ-9) to determine depression. Those who did not meet the age, disease duration, and regular follow up eligibility criteria were excluded from the study. Results: We enrolled 238 MS patients in the study, male patients represented 39.1% (n = 93) while females accounted for 60.9% (n = 145) (male:female ratio 0.64). The mean age of the study population was 32.07 ± 7.93 years. The mean duration of the disease was 7.06 ± 4.7 years. We determined that 89.9% (n = 214) of the patients showed mild to severe depression symptoms (55.46% of the females, and 34.4% of the males; p = 0.474). We further found that 37.39% (n = 89) and 65.13% (n = 155) of the depressed patients were unemployed (p = 0.039) and were non smokers (p = 0.097) respectively. Furthermore, depression severity is significantly associated with education (p = 0.005). Discussion: The medical care has a lot to be reviewed and improved within the framework of the association between chronic diseases and psychiatric disorders such as depression. Our approach differs from others in the literature since it operates a modified screening tool dedicated to the illness severity. In addition, the prevalence of depression in our model of MS patients was high probably because of maltreatment or failure of pharmacological and non-pharmacological means during the management plan. Lastly, our results show that higher level of education had a positive correlation with depression severities, which contradicts existing literature. Conclusion: High levels of depression symptoms were found among MS patients in Saudi Arabia. The relationship between MS and psychiatric conditions exists despite the uncertainty of its pathogenesis. Further longitudinal studies should be carried out to obtain more valid outcomes. Neurologists treating MS patients can play a role in studies related to the condition by investigating depressive symptoms actively and providing the data.