The Italian Journal of Neurological Sciences

, Volume 15, Issue 2, pp 97–101 | Cite as

Multiple sclerosis: correlation of anxiety, physical impairment and cognitive dysfunction

  • Stenager E. 
  • Knudsen L. 
  • Jensen K. 
Original Articles


The aim of the study was to examine the correlation between anxiety and physical impairment and to discover whether anxiety correlated with specific forms of cognitive dysfunction. Ninetyfour patients (42 females, 52 males) with definite MS entered the study. Anxiety was measured using the State-Trait Anxiety Inventory, physical impairment by means of the Kurtzke Disability Status scale, and cognitive impairment by using the Trail Making, Symbol Digit Modalities, Auditory Verbal Learning, Story Recall and the Recurring Figures tests. Moderately handicapped patients (DSS 4–5) showed signs of anxiety, and physical impairment correlated with anxiety (p<0.05; d.f. 1.92). Trail Making also correlated with anxiety (p<0.01; d.f. 1.86). On the basis of the results of this and previous studies, it is concluded that anxiety can be a sign of cognitive dysfunction, physical impairment or social strain.

Key Words

multiple sclerosis neuropsychology affective disorder symptom 


Scopo del presente lavoro è stato quello di esaminare la correlazione tra ansia e disabilità e di valutare se gli stati ansiosi fossero correlati con forme specifiche di disturbi cognitivi. Novantaquattro pazienti (42 femmine e 52 maschi) con SM definita sono stati reclutati nel presente studio. L'ansia è stata valutata secondo lo State-Trait Anxiety Inventory, la disabilità fisica mediante la scala di Kurtzke e per i disturbi cognitivi sono stati somministrati i seguenti test: Trail Making, Symbol Digit Modalities, Auditory Verbal Learning, Story Recall e Recurring Figures.

I pazienti con un handicap moderato (DSS 4–5) mostravano segni di ansia e il disturbo era correlato con lo stato di ansia (p<0.05; d.f. 1. 92). Pure il test Trail Making era correlato con l'ansia (p<0.01; d.f. 1.86). Sulla base di questi e di precedenti studi, si conclude che l'ansia quò essere un segno di disfunzione cognitiva, di disturbi fisici o di pressione sociale.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. [1]
    Baretz R.M., Stephenson G.R.:Emotional response to multiple sclerosis. Psychosomatics 22:117–27, 1981.PubMedGoogle Scholar
  2. [2]
    Beatty W.W., Goodkin D.E., Hertsgaard D., Monson N.:Clinical and demographic predictors of cognitive performance in multiple sclerosis. Arch. Neurol. 47: 305–308, 1990.PubMedGoogle Scholar
  3. [3]
    Bottenberg E.H., Lurati E.H., Lützenkirchen J., Grüninger W.:Multipler Sklerose und Stimmungslage. Archiv für Psychiatrie und Nervenkrankungen 220:27–36, 1975.Google Scholar
  4. [4]
    Colombo G., Armani M., Ferruzza E., Zuliani C.:Depression and neuroticism in multiple sclerosis. Ital. J. Neurol. Sci. 9:551–557, 1988.PubMedGoogle Scholar
  5. [5]
    Dalos N.P., Rabins P.V., Brooks B.R., O'Donnel P.:Disease activity and emotional state in multiple sclerosis. Ann. Neurol. 13:573–577, 1983.CrossRefPubMedGoogle Scholar
  6. [6]
    Jambor K.L.:Cognitive functioning in multiple sclerosis. Br. J. Psychiatry 115:765–775, 1969.PubMedGoogle Scholar
  7. [7]
    Jouvent R., Montreuil M., Benoit N., Lubetzki C., Tournier-Lasserne E., des Lauriers A., Widlöcher D., Lhermitte F., Lyon-Caen O.:Cognitive impairment, emotional disturbances and duration of multiple sclerosis. In Jensen K., Knudsen L., Stenager E., Grant I. (eds.) Mental disorders and cognitive deficits in multiple sclerosis. John Libbey & Co., London 139–145, 1989.Google Scholar
  8. [8]
    Kimura D. Neuropsychological test procedures. DK consultants. 26–28, 1988.Google Scholar
  9. [9]
    Kurtzke J.F.:Rating neurologic impairment in multiple sclerosis. Neurology 33: 1444–1452, 1983.PubMedGoogle Scholar
  10. [10]
    Lezak M.D.:Neuropsychological assesment. 2nd Edition. Oxford University Press. New York 1983.Google Scholar
  11. [11]
    Lyon-Caen O., Jouvent R., Hauser S., Chaunu M.P., Benoit N., Widlöcher D., Lhermitte F.:Cognitive function in recent onset demyelinating disease. Arch. Neurol. 43:1138–1141, 1986.PubMedGoogle Scholar
  12. [12]
    McIvoor G.P., Riklan M., Reznikoff M.:Depression in multiple sclerosis as a function of both length and severity of illness age, remissions and perceived social support. J. Clin. Psychol. 40: 1028–1033, 1984.Google Scholar
  13. [13]
    Mungas D.:Differential clinical sensitivity of specific parameters on the Rey Auditory Verbal Learning Test. J. Consult Clin. Psychol 51: 848–855, 1983.PubMedGoogle Scholar
  14. [14]
    Payne C.D.:The GLIM system release 2.77. London: Royal Statistical Society, 1987.Google Scholar
  15. [15]
    Poser C.M. Paty D., Scheinberg L., McDonald W.I., Davis F.A., Ebers G.C., Johnson K.P., Sibley W.A., Silberberg D.H., Tourtelotte W.W.:New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Ann. Neurol. 13:227–231, 1983.PubMedGoogle Scholar
  16. [16]
    Rao S.M., Hammeke T.A., Mc Quillen M.P., Khatri B.O., Lloyd D.:Memory disturbances in chronic progressive multiple sclerosis. Arch. Neurol. 41:625–631, 1984.PubMedGoogle Scholar
  17. [17]
    Rao S.M., Leo G.J., Ellington L., Naurtz T., Bernadin L., Unverzagt F.:Cognitive dysfunction in multiple sclerosis. Neurology 41:692–696, 1991.PubMedGoogle Scholar
  18. [18]
    Schiffer R.B.:The spectrum of depression in multiple sclerosis. An approach for clinical management. Arch. Neurol. 44:596–599, 1987.PubMedGoogle Scholar
  19. [19]
    Schiffer R.B., Wineman N.M.:Antidepressant pharmacotherapy of depression associated with multiple sclerosis. Am. J. Psychiatry 147:1493–1493, 1990.PubMedGoogle Scholar
  20. [20]
    Spielberger C.D., Gorsuch R.L., Luskene R.E.:The Stai Manual. Consulting Psychologists Press Inc. Palo Alto, California 1970.Google Scholar
  21. [21]
    Smith A.:Symbol Digit Modalities Test. Manual. Western Psychological Sciences. New York, 1973.Google Scholar
  22. [22]
    Stenager E., Knudsen L., Jensen K.:Historical notes on mental aspects of multiple sclerosis. In: Jensen K., Knudsen L., Stenager E., Grant I. (eds.). Mental disorders and cognitive deficits in multiple sclerosis. John Libbey & Co., London 1–7, 1989.Google Scholar
  23. [23]
    Stenager E., Knudsen L., Jensen K.:Correlation of Beck Depression Inventory score, Kurtzke Disability Status Scale and cognitive functioning in multiple sclerosis. In Jensen K., Knudsen L., Stenager E., Grant I. (eds.) Mental disorders and cognitive deficits in multiple sclerosis. John Libbey & Co., London, 147–151, 1989.Google Scholar
  24. [24]
    Stenager E., Knudsen L., Jensen K.:Psychiatric and cognitive aspects of multiple sclerosis. Semin. Neurol. 10:254–261, 1990.PubMedGoogle Scholar
  25. [25]
    Stenager E., Knudsen L., Jensen K.:Organic basis of mental disorders and cognitive deficits in multiple sclerosis. Nord. Med. 106:43–44, 49, 1991.PubMedGoogle Scholar
  26. [26]
    Stenager E., Knudsen L., Jensen K.:Multiple sclerosis: the impact of physical impairment and cognitive dysfunction on social and sparetime activities. Psychother Psychosom. 56:123–128, 1991.PubMedGoogle Scholar
  27. [27]
    Stenager E.N., Stenager E., Koch-Henriksen N., Brønnum-Hansen H., Kyllested K., Jensen K., Brahe U.B.:Suicide and multiple sclerosis. An epidemiological investigation. J. Neurol. Neurosurg. Psychiatr. 55:542–545, 1992.PubMedGoogle Scholar
  28. [28]
    Surrigde D.:An investigation into some aspects of multiple sclerosis. Br. J. Psychiatry 115:749–764, 1969.Google Scholar

Copyright information

© Masson S.p.A. 1994

Authors and Affiliations

  • Stenager E. 
    • 2
  • Knudsen L. 
    • 1
  • Jensen K. 
  1. 1.Neuropsychologist Clinical Neuro-Psychiatric Research UnitOdense University HospitalOdense CDenmark
  2. 2.Dept. of NeurologyOdense University HospitalOdense CDenmark

Personalised recommendations