More than one-third of people with myasthenia gravis (MG) experience anxiety and depression, brain and behaviorWe also show that the impact of these psychiatric disorders in these patients is higher than in patients with other autoimmune diseases.
A systemic review and meta-analysis are the first to characterize the prevalence of depression in these patients, according to the researchers. Studies have been conducted with mixed results and no systematic review or meta-analysis.
“MG primarily affects the acetylcholine receptors and disrupts their mechanisms. For most MG, the first symptoms are weakness of the extraocular muscles and misalignment of the eye, which is considered ocular MG.” writes the researcher. “Within 3 years, in about 90% of cases, ocular MG evolves into systemic MG. MG-induced disability often impacts the patient’s quality of life and interferes with daily life and activities.Additionally, MG symptom instability, disease prolongation, and steroid-induced disability Treatment can cause psychiatric symptoms in MG patients.”
Data were compiled from 38 studies involving more than 4000 patients, with a pooled prevalence of depression of 36% and a pooled prevalence of anxiety of 33%, both in multiple sclerosis. This rate was higher than previously seen for other autoimmune diseases such as lupus erythematosus and systemic lupus erythematosus. The rate of depression identified in this study was higher than that of other neurological disorders, including dementia (30.3%), amyotrophic lateral sclerosis (34%), multiple sclerosis (30.5%), and mild cognitive impairment. was higher than previously identified rates of depression in patients with (32%), a lower proportion than those with Alzheimer’s disease (42%).
Subgroup analyzes accounting for means, severity, study continent, disease duration, and study type found that the prevalence of mild, moderate, and severe depression was 27%, 14%, and 9%, respectively. showed that there is
Across the study, there was a wide range of impacts. The prevalence of depression ranged from 1% to 76% in individual studies, and the prevalence of anxiety ranged from 3% to 71% in individual studies.
This heterogeneity may be a result of the different methodological approaches and screening tools used in each study, the researchers explained. The most used screening tools for anxiety are the Beck Anxiety Inventory and the Hospital Anxiety and Depression Scale (HADS), and for depression the Beck Depression Inventory and the HADS, all of which have been validated and trusted in previous studies. proven to be viable.
Writing about other limitations of the study, the researchers noted, “Several of the included studies used self-report questionnaires to assess anxiety and depression in MG patients, and the reliability of the results was unreliable.” Finally, we could not completely ignore the possibility of publication bias.”
Nadali J, Ghavampour N, Beiranvand F, et al. Prevalence of depression and anxiety in patients with myasthenia gravis (MG): a systematic review and meta-analysis. brain behaviorPublished online December 10, 2022. doi:10.1002/brb3.2840