Studying the relationship between clinical features and mental health among late-onset myasthenia gravis patients

Lu Yu; Li Qiu; Hao Ran; Qian Ma; Ya-Ru Lu; Wei-Bin Liu

doi:10.5498/wjp.v12.i3.470

Studying the relationship between clinical features and mental health among late-onset myasthenia gravis patients

World J Psychiatry. 2022 Mar 19;12(3):470-482. doi: 10.5498/wjp.v12.i3.470.

Authors

Lu Yu¹, Li Qiu¹, Hao Ran², Qian Ma¹, Ya-Ru Lu¹, Wei-Bin Liu³

Affiliations

¹ Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
² School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou 510006, Guangdong Province, China.
³ Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China. liuwb@mail.sysu.edu.cn.

Abstract

Background: Mental disorders are common comorbidities among individuals with neurological diseases, and the prevalence of depressive and anxiety-related symptoms in newly referred patients at neurology outpatient clinics is high. There have been few studies on the mental health of patients with late-onset myasthenia gravis (MG).

Aim: To examine the relationship between clinical features and the mental health symptoms within late-onset MG patients.

Methods: A total of 105 patients diagnosed with MG were recruited consecutively from a neuromuscular outpatient clinic between December 2020 and February 2021. Patients were classified into two groups: early-onset MG (age at onset < 50 years, n = 63) and late-onset MG (age at onset ≥ 50 years, n = 42). Social demographic data and information about marital status, education level, clinical symptoms, serum antibody levels, and therapies used were collected for all participants. Participants were also evaluated using the Myasthenia Gravis Composite scale, the Myasthenia Gravis Activities of Daily Living scale, the Myasthenia Gravis Quality of Life 15 (MG-QOL-15) questionnaire, the 17-item version of the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). The relationship between clinical features and mental health in late-onset MG patients was examined using multivariate logistic regression analyses.

Results: Late-onset MG patients were more prone to dyspnea, had higher levels of serum anti-acetylcholine receptor antibodies, and higher total scores on the MG-QOL-15, HAM-D, and HAM-A questionnaires, than early-onset MG patients had (P < 0.05). Among those with late-onset MG, female patients had higher total HAM-D and HAM-A scores than male patients had (P < 0.05). High scores on the QOL-15 questionnaire were associated with higher incidences of anxiety and depression, and the association was found to be independent after adjusting for confounding risk factors. In the late-onset subgroup, the areas under the receiver operating characteristic curves for the MG-QOL-15 score-based diagnostic accuracy for anxiety and depression state were 0.816 (P = 0.001) and 0.983 (P < 0.001), respectively.

Conclusion: Higher MG-QOL-15 scores were a risk factor for anxiety and depression in late-onset MG, and women with late-onset MG were more likely to have anxiety and depression than men were.

Keywords: Anxiety; Depression; Late-onset myasthenia gravis; Mental health.