Anxiety, Depression in Patients With RRMS Tied to Poorer Clinical Outcomes

Individuals with relapsing-remitting multiple sclerosis (RRMS) with comorbid psychiatric conditions, like depression or anxiety, are more likely to experience poorer clinical outcomes, according to study results presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2025, held in West Palm Beach, Florida from February 27 to March 1.

Researchers at Rush University Medical Center in Chicago, Illinois conducted a retrospective chart review of 160 adults between the ages of 18 and 55 diagnosed with RRMS who had not yet received disease-modifying therapy (DMT). They collected baseline data, including comorbid medical and psychiatric conditions, demographic and socioeconomic factors such as insurance type, and Expanded Disability Status Scale (EDSS) scores.

After 18 months, the researchers assessed whether the presence of baseline depression or depression/anxiety was associated with insurance type, frequency of clinical relapses, treatment delays, progression of disability according to final EDSS scores, number of hospitalizations, and initial radiologic disease activity levels.

Individuals on Medicaid insurance were more likely to have comorbid depression (58%) or depression/anxiety (41%) compared with those without depression or depression/anxiety (19%; P <.001 for depression; P =.006 for depression/anxiety).

Presence of these comorbidities notably impacted clinical outcomes. Clinical relapses of RRMS occurred more often among individuals with depression (23%) or depression/anxiety (18%) compared with individuals without these psychiatric conditions (7%; P =.015 for depression; P =.034 for depression/anxiety).

Individuals with depression (38%) or depression/anxiety (30%) were also more likely to experience delays in receiving DMTs for MS compared with individuals without depression or depression/anxiety (16%; P =.007 for depression; P =.045 for depression/anxiety), which may have further contributed to worse clinical outcomes.

Consequently, depression correlated positively with progression of disability as evidenced by a mean increase of 1.59 points vs 0.92 points in EDSS scores for those with depression compared with those without depression (P =.04). Compared with individuals without depression, those with depression (15%) were also hospitalized at least 1 time or more (3%; P =.008).

Increased radiologic disease activity levels on initial magnetic resonance imaging (MRI) were significantly associated with comorbid depression/anxiety (37%) compared with those without depression/anxiety (22%; P =.047).

“Further studies are needed to determine the association of anxiety/depression and socioeconomic factors with negative outcomes in MS,” the researchers concluded.