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Publications

Journal Article Ahead of print

PubMed: 42241789 DOI: 10.1016/j.msard.2026.107280

Utility, validity and acceptability of survey depression and anxiety screening tools for routine multiple sclerosis clinic administration.

Mult Scler Relat Disord 112:107280

Authors: Ruby Hamer, Michelle Allan, David Skvarc, Emily Friedel, Andrew Giles, Jayashri Kulkarni, Jennifer Neil, Deepa Rajendran, Sally Shaw, Nigel Caswell, Vanessa Fanning, Sonia Marcon, Ernest Butler, Lisa Grech

Affiliations

  • School of Psychology, Deakin University, Burwood, Australia; Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia.
  • Department of Medicine at Monash Health, Monash University, Australia; Frankston Neurology, Frankston, Australia.
  • School of Psychology, Deakin University, Burwood, Australia.
  • MS Australia, North Sydney, Australia.
  • The Monash Alfred Psychiatry Research Centre, Monash University, Australia.
  • Monash School of Medicine, Monash University, Australia.
  • Department of Medicine at Monash Health, Monash University, Australia; Monash Medical Centre, Monash Health, Clayton, Australia.
  • Livology, Blackburn, Australia.
  • People with MS-Victoria, Australia.
  • Department of Medicine at Monash Health, Monash University, Australia; Frankston Neurology, Frankston, Australia; Department of Neurology, Peninsula Health, Frankston, Australia.
  • School of Psychology, Deakin University, Burwood, Australia; Department of Medicine at Monash Health, Monash University, Australia.

Abstract

BACKGROUND

Depression and anxiety are often undetected and untreated in individuals with multiple sclerosis (MS), despite a high prevalence of these conditions in this population. This study evaluated the clinical utility, diagnostic accuracy, and acceptability of depression and anxiety screeners and their integration into routine MS clinic appointments.

METHODS

Participants with MS (N = 207; age M = 47.3 ± 12.7 years, 77.3% female) were enrolled in this cross-sectional study conducted at an MS clinic in Melbourne, Australia. Consenting participants completed the Patient Reported Questionnaire-9 (PHQ-9) and the Depression, Anxiety and Stress Scale-21 (DASS-21) via an electronic tablet in the clinic waiting room or online for telehealth appointments, and underwent a Structured Clinical Interview for DSM-5 major depressive disorder and generalised anxiety disorder. Sensitivity, specificity, internal consistency, and patient comfort were assessed.

RESULTS

The PHQ-9 and DASS-21 depression subscales demonstrated excellent internal consistency (α=0.90-.93) and good diagnostic performance. For anxiety, DASS subscales showed moderate validity, with the stress subscale outperforming the anxiety subscale. Participants rated screening as highly acceptable (mean comfort score=7.7/10).

CONCLUSIONS

Among people with MS, self-administered depression and anxiety screening tools are valid and acceptable for routine use at MS clinic appointments. Tablet and online survey administration provide scalable options for integrating mental health assessment into standard care.

MeSH

Depression, Sclerosis, Multiple Sclerosis