Major depressive disorder subtypes and depression symptoms in multiple sclerosis: What is different compared to the general population?

Stephanie Rodgers; Pasquale Calabrese; Vladeta Ajdacic-Gross; Nina Steinemann; Marco Kaufmann; Anke Salmen; Zina-Mary Manjaly; Jürg Kesselring; Christian P Kamm; Jens Kuhle; Andrew Chan; Claudio Gobbi; Chiara Zecca; Stefanie Müller; Viktor von Wyl

doi:10.1016/j.jpsychores.2021.110402

Major depressive disorder subtypes and depression symptoms in multiple sclerosis: What is different compared to the general population?

J Psychosom Res. 2021 May:144:110402. doi: 10.1016/j.jpsychores.2021.110402. Epub 2021 Feb 16.

Authors

Affiliations

¹ Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland. Electronic address: stephanie.rodgers@uzh.ch.
² Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland.
³ Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland.
⁴ Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland.
⁵ Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
⁶ Department of Neurology, Schulthess Clinic, Zürich, Switzerland; Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland.
⁷ Department of Neurology and Neurorehabilitation, Rehabilitation Centre Kliniken Valens, Valens, Switzerland.
⁸ Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; Neurocentre, Luzerner Kantonsspital, Lucerne, Switzerland.
⁹ Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland.
¹⁰ Department of Neurology, Multiple Sclerosis Center (MSC), Neurocenter of Southern Switzerland, 6900 Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland.
¹¹ Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

PMID: 33631437
DOI: 10.1016/j.jpsychores.2021.110402

Abstract

Objective: To compare and characterize major depressive disorder (MDD) subtypes (i.e., pure atypical, pure melancholic and mixed atypical-melancholic) and depression symptoms in persons with multiple sclerosis (PwMS) with persons without MS (Pw/oMS) fulfilling the DSM-5 criteria for a past 12-month MDD.

Methods: MDD in PwMS (n = 92) from the Swiss Multiple Sclerosis Registry was compared with Pw/oMS (n = 277) from a Swiss community-based study. Epidemiological MDD diagnoses were based on the Mini-SPIKE (shortened form of the Structured Psychopathological Interview and Rating of the Social Consequences for Epidemiology). Logistic and multinomial regression analyses (adjusted for sex, age, civil status, depression and severity) were computed for comparisons and characterization. Latent class analysis (LCA) was conducted to empirically identify depression subtypes in PwMS.

Results: PwMS had a higher risk for the mixed atypical-melancholic MDD subtype (OR = 2.22, 95% CI = 1.03-4.80) compared to Pw/oMS. MDD in PwMS was specifically characterized by a higher risk of the two somatic atypical depression symptoms 'weight gain' (OR = 6.91, 95% CI = 2.20-21.70) and 'leaden paralysis' (OR = 3.03, 95% CI = 1.35-6.82) and the symptom 'irritable/angry' (OR = 3.18, 95% CI = 1.08-9.39).

Conclusions: MDD in PwMS was characterized by a higher risk for specific somatic atypical depression symptoms and the mixed atypical-melancholic MDD subtype. The pure atypical MDD subtype, however, did not differentiate between PwMS and Pw/oMS. Given the high phenomenological overlap with MS symptoms, the mixed atypical-melancholic MDD subtype represents a particular diagnostic challenge.

Keywords: Depression; Multiple sclerosis; Subtypes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Case-Control Studies
Depression / epidemiology*
Depressive Disorder, Major / classification*
Depressive Disorder, Major / epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Middle Aged
Multiple Sclerosis / epidemiology
Multiple Sclerosis / psychology*
Registries
Switzerland / epidemiology
Young Adult