Depressive symptoms and fatigue as predictors of objective-subjective discrepancies in cognitive function in multiple sclerosis
Open accessAbstract
Objective To examine the degree to which depressive symptoms and fatigue in individuals with multiple sclerosis (MS) are associated with discrepancies between subjective and objective cognitive impairment. Methods Ninety-nine adults with MS who were receiving care in a university-affiliated MS center completed the Patient Health Questionnaire-8 (PHQ-8), Fatigue Severity Scale (FSS), MS Neuropsychological Screening Questionnaire (MSNQ), and Brief International Cognitive Assessment for MS (BICAMS). Participants were classified as “Accurates,” “Underestimators,” or “Overestimators” based on discrepancies between their MSNQ (subjective) and BICAMS (objective) scores. Underestimators were individuals whose subjective scores were significantly worse than their objective scores. Overestimators exhibited the opposite profile. Results The PHQ-8 (r = 0.58) and FSS (r = 0.48) significantly correlated with the MSNQ, but not with the BICAMS (rs < 0.07). Underestimators (i.e., participants who underestimated their objective cognitive functioning) exhibited higher PHQ-8 and FSS scores compared to Accurates (ps < 0.01) and Overestimators (ps < 0.01). Optimal cut-scores of ≥6on the PHQ-8 and ≥36 on the FSS provided fair accuracy (78% and 74%) for identifying Underestimators. Identification of Underestimators based on PHQ-8 and FSS scores was not moderated by any demographic or MS clinical variables. Conclusions In the presence of mild levels of depression or significant fatigue, subjective cognitive measures are unlikely to provide accurate estimates of objective cognitive functioning. Objective cognitive measures are required for accurate identification of cognitive impairment.
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Cites
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · see citing works
Krupp, L. B. (1989) · Archives of Neurology · doi:10.1001/archneur.1989.00520460115022 · Cited by 6,172 · see citing works
The PHQ-8 as a measure of current depression in the general population
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.026 · Cited by 5,121 · see citing works
Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)
Langdon, D. W., Amato, M. P., Boringa, J., Brochet, B., Foley, F. W., Fredrikson, S., Hämäläinen, P. I., Hp, H., Krupp, L., Penner, I., et al. (2011) · Multiple Sclerosis Journal · doi:10.1177/1352458511431076 · Cited by 869 · see citing works
Fatigue in multiple sclerosis and its relationship to depression and neurologic disability
Bakshi, R., Shaikh, Z. A., Miletich, R. S., Czarnecki, D., Dmochowski, J., Henschel, K., Janardhan, V, Dubey, N., & Kinkel, P. R. (2000) · Multiple Sclerosis Journal · doi:10.1177/135245850000600308 · Cited by 480 · see citing works
Brief International Cognitive Assessment for MS (BICAMS): international standards for validation
Benedict, R., Amato, M., Boringa, J., Brochet, B., Foley, F., Fredrikson, S., Hämäläinen, P., Hartung, H., Krupp, L., Penner, I., et al. (2012) · BMC Neurology · doi:10.1186/1471-2377-12-55 · Cited by 430 · see citing works
Benedict, R. H. B., Munschauer, F. E., Linn, R. T., Miller, C., Murphy, E., Foley, F. W., & Jacobs, L. (2003) · Multiple Sclerosis Journal · doi:10.1191/1352458503ms861oa · Cited by 347 · see citing works
Reliable screening for neuropsychological impairment in multiple sclerosis
Benedict, R. H. B., Cox, D., Thompson, L. L., Foley, F., Weinstock‐Guttman, B., & Munschauer, F. E. (2004) · Multiple Sclerosis Journal · doi:10.1191/1352458504ms1098oa · Cited by 261 · see citing works
Comparing CESD-10, PHQ-9, and PROMIS depression instruments in individuals with multiple sclerosis.
Amtmann, D., Kim, J., Chung, H., Bamer, A. M., Askew, R. L., Wu, S., Cook, K. F., & Johnson, K. L. (2014) · Rehabilitation Psychology · doi:10.1037/a0035919 · Cited by 259 · see citing works
Kinsinger, S. W., Lattie, E. G., & Mohr, D. C. (2010) · Neuropsychology · doi:10.1037/a0019222 · Cited by 199 · see citing works
Comparison of the psychometric properties of two fatigue scales in multiple sclerosis.
Amtmann, D., Bamer, A. M., Noonan, V. K., Lang, N., Kim, J., & Cook, K. F. (2012) · Rehabilitation Psychology · doi:10.1037/a0027890 · Cited by 177 · see citing works
Dušánková, J. B., Kalinčík, T., Havrdová, E., & Benedict, R. H. B. (2012) · The Clinical Neuropsychologist · doi:10.1080/13854046.2012.725101 · Cited by 132 · see citing works
Multiple sclerosis in US minority populations
Khan, O. A., Williams, M. J., Amezcua, L., et al. (2015) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000000112 · Cited by 115 · see citing works
Julian, L. J., Merluzzi, N., & Mohr, D. C. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458506070255 · Cited by 110 · see citing works
The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue
Parmenter, B. A., Denney, D. R., & LYNCH, S. G. (2003) · Multiple Sclerosis Journal · doi:10.1191/1352458503ms859oa · Cited by 99 · see citing works
Golan, D., Doniger, G. M., Wissemann, K., et al. (2017) · Multiple Sclerosis Journal · doi:10.1177/1352458517695470 · Cited by 88 · see citing works
Depression in multiple sclerosis: A long-term longitudinal study
Koch, M., Patten, S., Berzins, S., Zhornitsky, S., Greenfield, J., Wall, W., & Metz, L. (2015) · Multiple Sclerosis · doi:10.1177/1352458514536086 · Cited by 86 · see citing works
Niino, M., Mifune, N., Kohriyama, T., Mori, M., Ohashi, T., Kawachi, I., Shimizu, Y., Fukaura, H., Nakashima, I., Kusunoki, S., et al. (2014) · BMC Neurology · doi:10.1186/1471-2377-14-3 · Cited by 81 · see citing works
Fatigue heralding multiple sclerosis
Berger, J. R., Pocoski, J., Preblick, R., & Boklage, S. (2013) · Multiple Sclerosis Journal · doi:10.1177/1352458513477924 · Cited by 78 · see citing works
Sjonnesen, K., Berzins, S., Fiest, K. M., Bulloch, A. G. M., Metz, L. M., Thombs, B. D., & Patten, S. B. (2012) · Postgraduate Medicine · doi:10.3810/pgm.2012.09.2595 · Cited by 68 · see citing works
Determinants and incidence of depression in multiple sclerosis: A prospective cohort study.
Berzins, S., Bulloch, A., Burton, J., Dobson, K., Fick, G. H., & Patten, S. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.06.012 · Cited by 38 · see citing works
Beier, M. L., Gromisch, E. S., Hughes, A. J., Alschuler, K. N., Madathil, R. L., Chiaravalloti, N. D., & Foley, F. W. (2017) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2017.08.019 · Cited by 38 · see citing works
Self-citationMultiple sclerosis in US minority populations: Clinical practice insights
Avasarala, J. R. (2015) · Neurology Clinical Practice · doi:10.1212/01.cpj.0000466889.88876.d0 · Cited by 16 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Delis DC, Kramer JH, Kaplan E, Ober BA, 2000 California Verbal Learning Test Manual: Second Edition, Adult Version. Psychological Corporation, San Antonio, TX.
- Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD, 1989a The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch. Neurol. 46, 1121– 1123. 2803071
Cited by
Sorted by citations
O'Keeffe, F., Cogley, C., McManus, C., Davenport, L., O'Connor, S., Tubridy, N., Gaughan, M., McGuigan, C., & Bramham, J. (2024) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2024.105719 · Cited by 4 · see citing works
- Authors
- Hughes, A. J., Bhattarai, J. (., Paul, S., & Beier, M.
- Affiliations
- Johns Hopkins University (US)
- Argosy University (US)
- Corresponding author
- Hughes, Abbey J.
- Venue
- Multiple Sclerosis and Related Disorders
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 30
- Pages
- 192-197
- ISSN
- 2211-0348 (ISSN-L)
- PMC
- PMC7282884
- OpenAlex
- W2914472328
- Semantic Scholar
- aa708f176cb7d765d74813f4e69e9ea51364052f
- Cited by
- 43
- References
- 24
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 11 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 2 · 2019: 2
- FWCI
- 3.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Multiple Sclerosis and Related Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (K23HD086154)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- multiple sclerosis, depressive symptoms, fatigue, cognitive impairment, PHQ-8, Fatigue Severity Scale, cut-off values
- MeSH terms
- Correlation of Data, Adult, Aged, Cognition Disorders, Depression, Fatigue, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Neuropsychological Tests, Psychiatric Status Rating Scales, Surveys and Questionnaires, Young Adult
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