Assessment of depression and anxiety in patients with multiple sclerosis depending on disease severity according to the EDSS

Background. The study was aimed at analyzing the impact of multiple sclerosis (MS) severity according to the Expanded Disability Status Scale (EDSS) on the physical and psycho-emotional state of patients, in particular on the level of depression, anxiety and self-assessment of health status. Objective: to determine the features of the psycho-emotional and physical state of patients with MS depending on disease severity on the EDSS and using standardized depression and anxiety assessment scales. Materials and methods. The cohort comprised 103 individuals with a confirmed MS diagnosis, categorized into three groups based on EDSS-assessed severity: mild (n = 54), moderate (n = 31), and severe (n = 18). Psychological state was assessed using the Hospital Anxiety and Depression Scale, the Beck Depression Inventory, and the Patient Health Questionnaire-9. Results. Patients with mild MS predominantly rated their health as good, whereas those with mo-derate MS frequently reported a fair condition, and individuals with severe MS commonly identified their health as poor. Notably, the highest median depression scores (10.5 [7; 11] points) and prevalence of clinically significant depression (50.00 %) were observed in the severe MS group. Subclinical anxiety was disproportionately prevalent among patients with moderate MS (35.48 %) compared to those with mild MS (14.81 %). The analysis revealed distinct trajectories for depression and anxiety depending on disease severity, with psychological distress intensifying in tandem with MS progression. Conclusions. The findings underscore the critical necessity of integrating MS severity into holistic assessments of physical and psycho-emotional health. The data advocate for comprehensive treatment paradigms encompassing both medical interventions and targeted psychosocial support to ameliorate depression, anxiety, and fatigue. These insights establish a framework for advancing personalized therapeutic strategies in MS management.