Title: Why Depression Goes Unrecognized in Multiple Sclerosis Patients
Abstract: Depression is very common among people with multiple sclerosis (MS). Unfortunately, many MS patients with depression do not receive a diagnosis of depression or adequate treatment for the condition. This study was undertaken to investigate screening tools used to assess depression in MS patients as well as the presentation of depression in MS. A total of 20 MS patients from the Texas Tech University Health Sciences Center MS clinic were screened for depression using the Two Question Screen (2QS), Beck Depression Inventory–Short Form (BDI-SF), and Patient Health Questionnaire–9 (PHQ-9). They were also evaluated for a possible major depressive episode (MDE). Results from each screening method were then compared with the corresponding findings from the MDE evaluation for each patient. In addition, each individual's depressive symptoms were quantified, characterized, and compared with screening results. The three depression screening tools yielded inconsistent results. The 2QS correlated best with the MDE evaluation findings. In addition, the number of overlapping symptoms in each patient was proportional to the likelihood of having a positive depression screen. The 2QS appears to be the best diagnostic tool available for detecting depression in MS patients. Clinicians also must be able to identify atypical signs of depression and overlapping symptoms between MS and depression and offer appropriate therapies for their management.