# The relationship between depression, anxiety, and disability in patients with multiple sclerosis: A cross‐sectional study from western Iran

## TL;DR

This study finds that depression and anxiety are strongly linked to increased disability in multiple sclerosis patients in western Iran.

## Contribution

The study provides new evidence on the relationship between psychological factors and disability in MS patients in a specific regional context.

## Key findings

- Depression and anxiety are significantly correlated with higher disability levels in MS patients.
- Depression and anxiety together explain 36.2% of the variance in disability.
- Lower education and family history of MS are linked to higher psychological distress.

## Abstract

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system often accompanied by psychological comorbidities such as depression and anxiety, which may aggravate physical disability. This study aimed to assess the relationship between depression, anxiety, and disability among patients with MS in western Iran.

A cross‐sectional analytical study was conducted among 180 MS patients attending the Boustan MS Clinic in Kermanshah, Iran. Participants completed the Persian versions of the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Disability was evaluated using the Expanded Disability Status Scale (EDSS). Data were analyzed using Spearman correlation and stepwise multiple regression.

The mean age of participants was 41.33 ± 9.09 years, and 75% were female. The mean EDSS score was 3.28 ± 1.56, BDI score 19.87 ± 10.21, and BAI score 13.28 ± 9.96. Depression and anxiety were significantly correlated with disability (r = 0.404 and r = 0.399, respectively; p < 0.01), and with each other (r = 0.702, p < 0.01). Regression analysis showed that depression alone explained 17.6% of disability variance, which increased to 36.2% when anxiety was added. Lower education level and positive family history of MS were associated with higher psychological distress.

Depression and anxiety are common and strongly associated with greater physical disability in MS patients. Integrating psychological assessment and intervention into MS management may help improve functional outcomes and quality of life.