Evidence map›Paper›PMID 23197840›Full record

Trial reportPsychosomatic medicine2013

Prospective examination of anxiety and depression before and during confirmed and pseudoexacerbations in patients with multiple sclerosis.

Michelle Nicole Burns, Ewa Nawacki, Juned Siddique, Daniel Pelletier, David C Mohr

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Psychosomatic medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00147446 (Phase II Study of the Effects of Stress Management on Neuroimaging, Clinical, Immune and Psychosocial Outcomes), which is not on this map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00147446 phase2completednot on this map

Phase II Study of the Effects of Stress Management on Neuroimaging, Clinical, Immune and Psychosocial Outcomes

TypeinterventionalSponsorNorthwestern UniversityRan2005 to 2009Enrolled121ConditionsMultiple SclerosisArmsIndividual Stress Management, Wait List Control
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Review
  6. Fatigue and depression influence the prevalence of anxiety in patients with multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  7. Article
  8. Review
  9. Behavioral Interventions in Multiple Sclerosis.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2020
    Article
  10. Wellness and the Role of Comorbidities in Multiple Sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2017
    Review
  11. Mental Health Comorbidity in MS: Depression, Anxiety, and Bipolar Disorder.Current neurology and neuroscience reports · 2016
    Review
  12. Article
  13. Predictors of anxiety in multiple sclerosis.Rehabilitation psychology · 2015
    Article
  14. Episodic Mood Changes Preceding an Exacerbation of Multiple Sclerosis.The primary care companion for CNS disorders · 2015
    Article
  15. Review
  16. [Coexistent depressive and anxiety disorders in epilepsy and multiple sclerosis: a challenge to neuropsychiatric practice].Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2014
    Review
  17. Review
  18. Article
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Michelle Nicole BurnsDepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Ewa Nawacki
Juned Siddique
Daniel Pelletier
David C Mohr

Funding

Multidisciplinary Clinical and Translational Science (MCTS) Program (UL1)UL1TR000150 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI LLOYD-JONES, DONALD M · 2012 to 2013
$10.1M
A Controlled Trial of CBT for Multiple Sclerosis InflammationR01HD043323 · NICHD · NORTHERN CALIFORNIA INSTITUTE RES &EDUC · PI DAIKH, DAVID I · 2003 to 2010
$7.3M
Tech-Based Depression and Anxiety Treatment for Youth in High Risk EnvironmentsK08MH094441 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI BURNS, MICHELLE NICOLE · 2012 to 2016
$805k
Real Time Analysis of Diet and Activity DataK07CA154862 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SIDDIQUE, JUNED · 2011 to 2015
$585k
NCATS NIH HHS UL1 TR000150NCI NIH HHS K07-CA154862-01NICHD NIH HHS R01 HD043323NICHD NIH HHS R01-HD043323NIMH NIH HHS K08 MH094441NIMH NIH HHS K08-MH094441-01A1
6 · The paper itself

Abstract

objectiveThis study was designed to determine whether pseudoexacerbations and confirmed MS exacerbations are preceded by or concurrent with increased anxiety or depressive symptoms.

methodsThis was a secondary analysis of 121 patients with MS who were observed for 48 weeks during a randomized controlled trial. Participants completed monthly self-reports on depressive and anxiety symptoms. Patient-reported exacerbations were assessed through a telephone-administered symptom checklist and neurologic examination.

resultsBoth pseudoexacerbations and confirmed exacerbations were associated with concurrent somatic depressive (β = .16 and β = .33, respectively; p values < .05), affective depressive (β = .17 [p = .02] and β = .12 [p = .06]), and anxiety symptoms (β = .24 and β = .20, p values < .01), controlling for baseline symptoms. Preexisting somatic and affective depressive symptoms predicted amplified relationships between concurrent confirmed exacerbations and these symptoms (β = .19 and β = .20, respectively; p values < .01). A standard deviation increase in anxiety symptoms relative to baseline predicted subsequent onset of pseudoexacerbations (odds ratio = 1.54, p = .02), whereas increased somatic depressive symptoms predicted confirmed exacerbations (odds ratio = 1.59, p = .01).

conclusionsPatients with MS experiencing pseudoexacerbations or confirmed exacerbations should be assessed and monitored for depressive and anxiety symptoms, and confirmed exacerbations are particularly concerning in patients with a history of depression. The psychological or psychiatric antecedents of MS exacerbations generate new hypotheses on etiologies of confirmed exacerbations and pseudoexacerbations.

trial registrationclinicaltrials.gov Identifier: NCT00147446.

Indexed as

Disease ProgressionAdultAnxietyAnxiety DisordersDepressionDepressive DisorderFemaleHumansLinear ModelsLongitudinal StudiesMaleMiddle AgedMultiple SclerosisOdds RatioProspective StudiesSurveys and Questionnaires

Identifiers

PMID23197840
PMCPMC3538885

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.