Validation of mood measures for people with multiple sclerosis

Abstract

Background: Valid assessments are needed in order to identify anxiety and depression in people with multiple sclerosis (MS). The objective of this study was to assess the validity of questionnaire measures of mood in people with MS.

Methods: People with MS were recruited from a clinic database and asked to complete and return a questionnaire containing the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and Hospital Anxiety and Depression Scale (HADS). Those who returned the questionnaire were invited to complete a structured clinical interview, which was blind to the results of the questionnaire.

Results: The BDI-II and HADS were both found to be valid measures to detect depression and anxiety in people with MS. An optimum cutoff score of 23 for the BDI-II yielded high sensitivity (85%) and high specificity (76%). An optimum cutoff score of 11 for the HADS demonstrated high sensitivity and specificity for both the Anxiety subscale (sensitivity 90%, specificity 92%) and the Depression subscale (sensitivity 77%, specificity 81%). The BAI had high sensitivity (80%) but poor specificity (46%) for detecting anxiety.

Conclusion: The BDI-II and HADS can be used to identify mood disorders in people with MS.

Figure 1.

Receiver operating characteristic (ROC) curves to determine optimum cutoffs on questionnaires: classification of anxiety A, Hospital Anxiety and Depression Scale (HADS) Anxiety subscale; B, Beck Anxiety Inventory (BAI). Diagonal segments are produced by ties.

Figure 2.

Receiver operating characteristic (ROC) curves to determine optimum cutoffs on questionnaires: classification of depression A, Hospital Anxiety and Depression Scale (HADS) Depression subscale; B, Beck Depression Inventory (BDI). Diagonal segments are produced by ties.