https://orcid.org/0000-0002-3844-1800
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Furkan Bahadır Alptekin, Didem Savaşçı, Betül Karaaslan, Özge Aşık, Ebrar Torlak, Anxiety in multiple sclerosis: an exploratory cross-sectional study of psychological, social, clinical, and neuroimaging factors, Archives of Clinical Neuropsychology, Volume 41, Issue 5, August 2026, acag050, https://doi.org/10.1093/arclin/acag050
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Abstract
Anxiety is a common but often overlooked psychiatric comorbidity in multiple sclerosis (MS), significantly affecting quality of life. This cross-sectional study examined anxiety in MS patients using a biopsychosocial framework, aiming to identify differences from healthy controls and determine predictive factors.
We compared 101 MS patients with 136 healthy controls using numeric rating scales for pain and fatigue, Hospital Anxiety and Depression Scale (HADS), Brief Resilience Scale, Acceptance and Action Questionnaire–II (AAQ-II), and multidimensional scale of perceived social support. Clinical data included Expanded Disability Status Scale (EDSS) scores and MRI measurements. Analyses included t-tests, Pearson correlations, and hierarchical regression.
Patients with MS had significantly higher HADS-Anxiety scores (M = 8.71, SD = 4.35) than healthy controls (M = 7.53, SD = 3.58; p = .023), with 30.7% meeting the clinical threshold for anxiety. Hierarchical regression analysis identified psychological inflexibility (β = 0.318, p < .001), depression (β = 0.264, p = .007), and female sex (β = 0.395, p = .032) as significant predictors of anxiety in patients with MS, explaining 48% of the total variance. Importantly, neurological disability, structural brain measures, clinical symptoms, and social support were not significant predictors of anxiety. However, EDSS scores were significantly associated with AAQ-II scores (r = 0.309, p = .002).
Anxiety in MS is primarily influenced by psychological factors, particularly psychological inflexibility and comorbid depression, rather than biological variables. Findings support acceptance and commitment therapy–based interventions and routine psychiatric screening.
