Evaluation of relapsing remitting multiple sclerosis patients with or without immunomodulatory therapy with depression, anxiety and fatigue scales

Multiple sclerosis (MS) is a chronic, autoimmune, demyelinating, inflammatory and neurodegenerative central nervous system disease characterized by more of the white matter in the central nervous system, with demyelinating plaques that can affect the deep gray matter and cortex, and axon damage. The diagnosis of MS is mainly a clinical diagnosis, with the symptoms and signs taking into account the clinical course of the disease. In the treatment of MS; attack treatment, preventive treatment, symptomatic treatment and rehabilitation treatment are applied. Fatigue, which is one of the most common complaints in patients with MS, is seen at approximately 78%. In addition, approximately 80% of individuals with MS have at least one mental symptom, primarily anxiety and depression. Various studies report a 34% incidence of anxiety in MS patients. The purpose of this study; To determine the relationship between depression, anxiety and fatigue rates of patients diagnosed with Relapsing Remitting Multiple Sclerosis (RRMS) who received immunomodulatory treatment in MS and who did not receive any treatment. to the extent that it affects. 123 patients diagnosed with MS according to McDonald criteria were included in the study. RRMS patients with the diagnosis of RRMS, who have received any of the immunomodulatory (Finfolimod, Glatiramer Acetate, interferon beta 1a) treatments for the past 1 year and whose EDSS score is below 5; Patients who had been diagnosed with MS clinic and diagnosed for at least 1 year and did not receive any treatment were included. A total of 123 patients, including 30 using fingolimod, 31 using Glatiramer Acetate, 31 using Interferon-Beta 1-a and 31 without immunomodulatory therapy, were included in the study. Beck Depression Inventory (BDI) and Montgomery Asberg Depression Rating Scale (MADÖ-MADRS) were used for the diagnosis of depression, Beck Anxiety Scale for the diagnosis of anxiety and Fatigue Severity Scale-YŞÖ for the diagnosis of fatigue. While 49 (39.8%) of 123 patients included in the study had depression according to Beck depression scale score, 74 patients (60.2%) did not have depression. While 20 patients (64.5%) did not receive any depression according to the Beck depression scale, no depression was detected in 11 patients (35.5%). No statistically significant difference was found between the treated group and the non-treated group according to the Beck depression scale score (p> 0.05). Beck depression scale scores did not differ according to drug types (p = 0.391). The mean values of the anxiety severity scale were also statistically different according to the drug use status (p> 0.05). The mean anxiety values did not differ according to drug types (p = 0.672). In our study, the values of fatigue severity scale did not differ between patients who received drug therapy and did not receive any treatment (p> 0.05). Again, there was no statistically significant difference in terms of drug types used in Fatigue severity scale scores (p = 0.667). As a result, when comparing RRMS patients with and without different immunomodulatory treatments, the groups were not different in terms of depression, fatigue and anxiety symptoms; suggests that these symptoms may be related more to the duration and severity of MS disease. Fatigue and psychiatric symptoms detected in MS are as important as neurological symptoms and require us to take a holistic approach to the disease. Keywords: Multiple Sclerosis, depression, anxiety, fatigue