In the presence of mild levels of depression or significant fatigue in persons with multiple sclerosis (MS), subjective cognitive measures are unlikely to provide accurate estimates of objective cognitive functioning. This according to a recent study that aimed to examine the degree to which depressive symptoms and fatigue in individuals with MS are associated with discrepancies between subjective and objective cognitive impairment. 99 adults with MS completed the Patient Health Questionnaire–8 (PHQ-8), Fatigue Severity Scale (FSS), MS Neuropsychological Screening Questionnaire (MSNQ), and Brief International Cognitive Assessment for MS (BICAMS). Participants were classified as “Accurates,” “Underestimators,” or “Overestimators” based on discrepancies between their MSNQ (subjective) and BICAMS (objective) scores. Researchers found:
- The PHQ-8 ( r=.58) and FSS ( r=.48) significantly correlated with the MSNQ, but not with the
BICAMS ( rs<.07). - Underestimators (ie, participants who underestimated their objective cognitive functioning) exhibited higher PHQ-8 and FSS scores compared to Accurates and Overestimators.
- Optimal cut-scores of ≥6 on the PHQ-8 and ≥36 on the FSS provided fair accuracy (78% and 74%) for identifying Underestimators.
- Identification of Underestimators based on PHQ-8 and FSS scores was not moderated by any demographic or MS clinical variables.
Hughes AJ. Depressive symptoms and fatigue as predictors of objective-subjective discrepancies in cognitive function in multiple sclerosis. [Published online ahead of print January 31, 2019]. Mult Scler Relat Disord. doi:10.1016/j.msard.2019.01.055.