{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:31:03Z","timestamp":1777937463568,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000033","name":"Institute of Musculoskeletal Health and Arthritis","doi-asserted-by":"publisher","award":["THC-135234"],"award-info":[{"award-number":["THC-135234"]}],"id":[{"id":"10.13039\/501100000033","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000261","name":"Multiple Sclerosis Society of Canada","doi-asserted-by":"publisher","award":["EGID 2639"],"award-info":[{"award-number":["EGID 2639"]}],"id":[{"id":"10.13039\/501100000261","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007658","name":"Crohn's and Colitis Canada","doi-asserted-by":"publisher","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/501100007658","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"canadian institutes of health research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Longitudinal studies assessing depression and anxiety effects on cognition in multiple sclerosis (MS) are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We tested whether within-person fluctuations in symptoms of depression or anxiety over time affect cognition in persons with MS, inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and a lifetime history of depression\/anxiety disorders (DEP\/ANX) but without an immune-mediated inflammatory diseases (IMID).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We followed participants (MS: 255, IBD: 247, RA: 154, and DEP\/ANX: 306) for 3\u2009years. Annually, they completed the hospital anxiety and depression scale (HADS) and cognitive tests including the symbol digit modalities test (SDMT). We evaluated associations of elevated symptoms (scores\u2009\u2a7e\u200911) of anxiety (HADS-A) and depression (HADS-D) with SDMT z-scores using multivariable linear models\u2014estimating between-person and within-person effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Participants with MS performed worse on the SDMT than participants in the DEP\/ANX cohort (\u03b2\u2009=\u2009\u22120.68; 95% CI: \u22120.88, \u22120.48). Participants with elevated HADS-A scores performed worse on the SDMT than those without elevated scores (\u03b2\u2009=\u2009\u22120.43; 95% CI: \u22120.65, \u22120.21), particularly those with RA. Time-varying within-person elevations in depressive symptoms were associated with worse SDMT performance (\u03b2\u2009=\u2009\u22120.12; 95% CI: \u22120.21, \u22120.021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Across persons, elevated symptoms of anxiety adversely affected information processing. Elevated symptoms of depression within-persons over time were associated with declines in information processing speed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458520961534","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T12:15:25Z","timestamp":1601036125000},"page":"1284-1292","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Anxiety and depression affect performance on the symbol digit modalities test over time in MS and other immune disorders"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1855-5595","authenticated-orcid":false,"given":"Ruth Ann","family":"Marrie","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada\/Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronak","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Clinical Health Psychology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles N","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M","family":"Bolton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley A","family":"Graff","sequence":"additional","affiliation":[{"name":"Department of Clinical Health Psychology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James J","family":"Marriott","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol A","family":"Hitchon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chase R","family":"Figley","sequence":"additional","affiliation":[{"name":"Department of Radiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada\/Division of Diagnostic Imaging, Health Sciences Centre, Winnipeg, MB, Canada\/Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Health Sciences Centre, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Kornelsen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada\/Division of Diagnostic Imaging, Health Sciences Centre, Winnipeg, MB, Canada\/Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Health Sciences Centre, Winnipeg, MB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D","family":"Fisk","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, 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