Factors associated with depressive state in patients with myasthenia gravis: A multicentre cross-sectional study

Yasushi Suzuki, Kimiaki Utsugisawa, Shigeaki Suzuki, Yuriko Nagane, Masayuki Masuda, Chiaki Kabasawa, Yuko Shimizu, Hiroya Utsumi, Shinichiro Uchiyama, Kazuo Fujihara, Norihiro Suzuki

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Abstract

Objectives: The objective of this study was to examine clinical factors associated with depressive state in patients with myasthenia gravis (MG). Design: Cross-sectional study. Setting and participants: We evaluated 287 consecutive cases of MG seen at six neurological centres located in Eastern Japan. Outcome measures: All MG patients completed the Japanese version of the Beck Depression InventoryeSecond Edition (BDI-II). Disease severity was determined according to the MG Foundation of America (MGFA) quantitative MG score, MG activities of daily living scale and MG composite scale (MG composite). Clinical state following treatment was categorised according to MGFA postintervention status. Associations between detailed clinical parameters of MG and BDI-II score were then examined statistically. Results: Mean BDI-II score for patients with MG (11.0±8.1) did not differ substantially from and overlapped with that reported as the Japanese standard (8.7±6.4). The mean +2 SDs for the Japanese standard is 21.5, approximately equal to the cut-off level indicative of moderate or worse depression (> 20 points) in the original English version. We thus defined BDI-II >21.5 as depressive state, with a frequency of 13.6% in patients with MG. Multivariate logistic regression analysis revealed current dose of oral prednisolone (OR 1.09, 95% CI 1.02 to 1.17; p=0.01), unchanged MGFA postintervention status (OR 3.55, 95% CI 1.18 to 10.71; p=0.02), time since onset (OR 0.93, 95% CI 0.87 to 0.99; p=0.03) and MG composite (OR 1.16, 95% CI 1.00 to 1.34; p=0.046) as factors independently associated with depressive state in MG. Conclusions: Dose of oral corticosteroids appears to represent the major factor associated with depressive state in MG. Unchanged status despite treatment and early disease stage are also significant background factors for depressive state, along with disease severity.

Original languageEnglish
Article numbere000313
JournalBMJ Open
Volume1
Issue number2
DOIs
Publication statusPublished - 2011

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Myasthenia Gravis
Cross-Sectional Studies
Activities of Daily Living
Prednisolone
Japan
Adrenal Cortex Hormones

ASJC Scopus subject areas

  • Medicine(all)

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Factors associated with depressive state in patients with myasthenia gravis : A multicentre cross-sectional study. / Suzuki, Yasushi; Utsugisawa, Kimiaki; Suzuki, Shigeaki; Nagane, Yuriko; Masuda, Masayuki; Kabasawa, Chiaki; Shimizu, Yuko; Utsumi, Hiroya; Uchiyama, Shinichiro; Fujihara, Kazuo; Suzuki, Norihiro.

In: BMJ Open, Vol. 1, No. 2, e000313, 2011.

Research output: Contribution to journalArticle

Suzuki, Y, Utsugisawa, K, Suzuki, S, Nagane, Y, Masuda, M, Kabasawa, C, Shimizu, Y, Utsumi, H, Uchiyama, S, Fujihara, K & Suzuki, N 2011, 'Factors associated with depressive state in patients with myasthenia gravis: A multicentre cross-sectional study', BMJ Open, vol. 1, no. 2, e000313. https://doi.org/10.1136/bmjopen-2011-000313
Suzuki, Yasushi ; Utsugisawa, Kimiaki ; Suzuki, Shigeaki ; Nagane, Yuriko ; Masuda, Masayuki ; Kabasawa, Chiaki ; Shimizu, Yuko ; Utsumi, Hiroya ; Uchiyama, Shinichiro ; Fujihara, Kazuo ; Suzuki, Norihiro. / Factors associated with depressive state in patients with myasthenia gravis : A multicentre cross-sectional study. In: BMJ Open. 2011 ; Vol. 1, No. 2.
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abstract = "Objectives: The objective of this study was to examine clinical factors associated with depressive state in patients with myasthenia gravis (MG). Design: Cross-sectional study. Setting and participants: We evaluated 287 consecutive cases of MG seen at six neurological centres located in Eastern Japan. Outcome measures: All MG patients completed the Japanese version of the Beck Depression InventoryeSecond Edition (BDI-II). Disease severity was determined according to the MG Foundation of America (MGFA) quantitative MG score, MG activities of daily living scale and MG composite scale (MG composite). Clinical state following treatment was categorised according to MGFA postintervention status. Associations between detailed clinical parameters of MG and BDI-II score were then examined statistically. Results: Mean BDI-II score for patients with MG (11.0±8.1) did not differ substantially from and overlapped with that reported as the Japanese standard (8.7±6.4). The mean +2 SDs for the Japanese standard is 21.5, approximately equal to the cut-off level indicative of moderate or worse depression (> 20 points) in the original English version. We thus defined BDI-II >21.5 as depressive state, with a frequency of 13.6{\%} in patients with MG. Multivariate logistic regression analysis revealed current dose of oral prednisolone (OR 1.09, 95{\%} CI 1.02 to 1.17; p=0.01), unchanged MGFA postintervention status (OR 3.55, 95{\%} CI 1.18 to 10.71; p=0.02), time since onset (OR 0.93, 95{\%} CI 0.87 to 0.99; p=0.03) and MG composite (OR 1.16, 95{\%} CI 1.00 to 1.34; p=0.046) as factors independently associated with depressive state in MG. Conclusions: Dose of oral corticosteroids appears to represent the major factor associated with depressive state in MG. Unchanged status despite treatment and early disease stage are also significant background factors for depressive state, along with disease severity.",
author = "Yasushi Suzuki and Kimiaki Utsugisawa and Shigeaki Suzuki and Yuriko Nagane and Masayuki Masuda and Chiaki Kabasawa and Yuko Shimizu and Hiroya Utsumi and Shinichiro Uchiyama and Kazuo Fujihara and Norihiro Suzuki",
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T1 - Factors associated with depressive state in patients with myasthenia gravis

T2 - A multicentre cross-sectional study

AU - Suzuki, Yasushi

AU - Utsugisawa, Kimiaki

AU - Suzuki, Shigeaki

AU - Nagane, Yuriko

AU - Masuda, Masayuki

AU - Kabasawa, Chiaki

AU - Shimizu, Yuko

AU - Utsumi, Hiroya

AU - Uchiyama, Shinichiro

AU - Fujihara, Kazuo

AU - Suzuki, Norihiro

PY - 2011

Y1 - 2011

N2 - Objectives: The objective of this study was to examine clinical factors associated with depressive state in patients with myasthenia gravis (MG). Design: Cross-sectional study. Setting and participants: We evaluated 287 consecutive cases of MG seen at six neurological centres located in Eastern Japan. Outcome measures: All MG patients completed the Japanese version of the Beck Depression InventoryeSecond Edition (BDI-II). Disease severity was determined according to the MG Foundation of America (MGFA) quantitative MG score, MG activities of daily living scale and MG composite scale (MG composite). Clinical state following treatment was categorised according to MGFA postintervention status. Associations between detailed clinical parameters of MG and BDI-II score were then examined statistically. Results: Mean BDI-II score for patients with MG (11.0±8.1) did not differ substantially from and overlapped with that reported as the Japanese standard (8.7±6.4). The mean +2 SDs for the Japanese standard is 21.5, approximately equal to the cut-off level indicative of moderate or worse depression (> 20 points) in the original English version. We thus defined BDI-II >21.5 as depressive state, with a frequency of 13.6% in patients with MG. Multivariate logistic regression analysis revealed current dose of oral prednisolone (OR 1.09, 95% CI 1.02 to 1.17; p=0.01), unchanged MGFA postintervention status (OR 3.55, 95% CI 1.18 to 10.71; p=0.02), time since onset (OR 0.93, 95% CI 0.87 to 0.99; p=0.03) and MG composite (OR 1.16, 95% CI 1.00 to 1.34; p=0.046) as factors independently associated with depressive state in MG. Conclusions: Dose of oral corticosteroids appears to represent the major factor associated with depressive state in MG. Unchanged status despite treatment and early disease stage are also significant background factors for depressive state, along with disease severity.

AB - Objectives: The objective of this study was to examine clinical factors associated with depressive state in patients with myasthenia gravis (MG). Design: Cross-sectional study. Setting and participants: We evaluated 287 consecutive cases of MG seen at six neurological centres located in Eastern Japan. Outcome measures: All MG patients completed the Japanese version of the Beck Depression InventoryeSecond Edition (BDI-II). Disease severity was determined according to the MG Foundation of America (MGFA) quantitative MG score, MG activities of daily living scale and MG composite scale (MG composite). Clinical state following treatment was categorised according to MGFA postintervention status. Associations between detailed clinical parameters of MG and BDI-II score were then examined statistically. Results: Mean BDI-II score for patients with MG (11.0±8.1) did not differ substantially from and overlapped with that reported as the Japanese standard (8.7±6.4). The mean +2 SDs for the Japanese standard is 21.5, approximately equal to the cut-off level indicative of moderate or worse depression (> 20 points) in the original English version. We thus defined BDI-II >21.5 as depressive state, with a frequency of 13.6% in patients with MG. Multivariate logistic regression analysis revealed current dose of oral prednisolone (OR 1.09, 95% CI 1.02 to 1.17; p=0.01), unchanged MGFA postintervention status (OR 3.55, 95% CI 1.18 to 10.71; p=0.02), time since onset (OR 0.93, 95% CI 0.87 to 0.99; p=0.03) and MG composite (OR 1.16, 95% CI 1.00 to 1.34; p=0.046) as factors independently associated with depressive state in MG. Conclusions: Dose of oral corticosteroids appears to represent the major factor associated with depressive state in MG. Unchanged status despite treatment and early disease stage are also significant background factors for depressive state, along with disease severity.

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