Depression, Anxiety Reported by 1 in 3 MG Patients, Analysis Shows

Calling rates 'high,' researchers stress need for patient support

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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More than one in three people with myasthenia gravis (MG) have clinically relevant depression, and a similar proportion have anxiety, a new large-scale analysis found.

These rates are high, even compared with other autoimmune diseases, according to the researchers, who stressed the importance of providing care and support to help patients cope with mental health challenges.

“Symptoms such as depression and anxiety in MG patients are often overlooked or delayed in diagnosis, leading to an increase in severity of symptoms and delayed onset of treatment,” the researchers wrote, adding that “identifying the related factors and developing effective intervention strategies for MG patients are needed.”

The study, “Prevalence of depression and anxiety among myasthenia gravis (MG) patients: A systematic review and meta-analysis,” was published in the journal Brain and Behavior.

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Mental health problems common in MG

Living with a chronic health condition like MG can take a toll on mental health. While many studies have evaluated the psychological status of people living with MG, estimates on the prevalence of mental health problems like anxiety and depression have tended to vary widely from study to study.

To get a better understanding of how common these problems are among MG patients, scientists in Iran conducted a meta-analysis — a type of study in which researchers pool data from multiple previously published studies and analyze them all collectively.

This analysis included data from 38 previous studies published from 2000 to 2021, covering 4,108 people with MG living across 20 countries in America, Europe, Asia, and Africa.

“To the extent of our knowledge, this study is the first systematic review and meta-analysis that investigated the prevalence of overall anxiety and depression in MG,” the researchers wrote.

The results showed that the overall prevalence of clinically relevant depression was 36%. The prevalence of anxiety was 33%. According to researchers, these rates are comparable to, or even slightly higher than those reported in other autoimmune diseases like multiple sclerosis and lupus.

“According to our results, anxiety and depression are major problems among MG patients and the prevalence of both anxiety and depression is high even when compared to other autoimmune diseases,” they wrote.

The team noted that there was substantial variation across the included studies in reported rates of anxiety and depression, with some studies reporting rates under 5%, while others reported rates higher than 70%.

One potential factor that appeared to affect these rates was location. The highest rates of depression were reported in Europe (56%), and the highest rates of anxiety in America (53%). Studies done in Asia, meanwhile, reported the lowest rates of both depression (28%) and anxiety (25%).

Differences in which tests were used to evaluate mental health outcomes likely also played a role in study-to-study variation, the researchers said. Analyses also suggested a significant effect of publication bias — a phenomenon in which results that are “more interesting” are more likely to be published, ultimately skewing the available data in the published scientific literature.

Overall, the team noted, this study highlights how important it is that clinicians be proactively asking about mental health challenges in people with MG, so that support can be given where it is needed.