Effects of depression and anxiety on quality of life in five common neurological disorders

Abstract

Background It is unclear whether anxiety and depression impact health-related quality of life (HRQoL) equally across neurological diseases. This study examines the association between anxiety or depression and HRQoL in select neurological disorders.Methods HRQoL was measured using the Short Form Health Survey (SF-12) in neurological patients: epilepsy (n = 279), migraine (n = 268), multiple sclerosis (MS) (n = 222), stroke (n = 204), and Parkinson's disease (PD) (n = 224). Depression and anxiety symptoms were assessed using the Patient Health Questionnaire (PHQ-9) and Hospital Anxiety and Depression Scale (HADS-A), respectively. Multiple linear regression was used to evaluate variables associated with the SF-12 mental health component (MCS) and physical health component scores (PCS). Pratt index was used to estimate the relative importance of anxiety and depression on HRQoL.Results Anxiety and depression had the largest contribution to PCS in stroke and to MCS in epilepsy. Overall, anxiety and depression had a larger contribution to MCS as compared to PCS, except in stroke patients. Different patterns were seen across neurological diseases, with mental health variables strongly affecting MCS in all conditions, with also a sizable contribution to PCS in migraine, MS, and stroke.Conclusions Anxiety and depression have varying impacts on HRQoL across neurological diseases. It is important for clinicians to be aware of how these patterns differ in each condition.