Depression and Anxiety in Neuromyelitis Optica Spectrum Disease (NMOSD): Analysis of a National Dataset
Esther Zeng1, Abigail Sorenson1, Tammy Smith2, Melissa Wright2, Aditi Sharma2, Trieste Francis2, John Rose2, Ka-Ho Wong2, Stacey Clardy2
1University of California, Berkeley, 2University of Utah
Objective:
Determine the frequency of depression and anxiety in a neuromyelitis optica spectrum disease (NMOSD) population pre and post NMOSD diagnosis.
Background:
NMOSD is an antibody-mediated autoimmune disorder affecting the central nervous system (CNS), mainly targeting the optic nerves and spinal cord. Increased rates of depression and anxiety have been recorded in relation to demyelinating diseases such as multiple sclerosis (MS). However, there is a dearth of literature on the prevalence of depression and anxiety in NMOSD pre diagnosis.
Design/Methods:
NMOSD diagnosis code was queried to form a de-identified aggregate dataset focused on United States patients: TriNetX is a global research network covering 68 US hospital systems. The NMOSD diagnosis dates range from 1992 to 2022. To increase specificity, patients who had less than three NMOSD ICD-10-CM (G36.0) code entries were removed. Additionally we only included patients with NMOSD related symptom ICD-10-CM diagnosis codes.
Results:
1885 unique patients met the inclusion criteria for further analysis. Of this population 1444 (76.9%) were female, the median age was 50.75y [3.75 – 90.75], 968 (51.3%) were white, 591 (30.4%) were black, 62 (3.4%) were Asian, and 256 (14.4%) were unknown. For this population, 788 (42.8%) patients carried an anxiety and/or depression ICD-10-CM diagnosis code. 543 (28.81%) patients received a depression diagnosis. Of these 543 depression patients 317 (58.38%) were diagnosed before the NMOSD confirmation. 489 (25.94%) patients received an anxiety diagnosis. Of these 489 patients 295 (60.33%) received the diagnosis before their NMOSD confirmation.
Conclusions:
Depression and anxiety diagnoses are coded in approximately two-fifths of all NMOSD patients in the cohort; over half of whom were diagnosed with anxiety/depression before their NMOSD diagnosis. Given the complexities of the illness and its management, clinicians must be vigilant in remembering to query for depression and anxiety during patients visits.