{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:16:28Z","timestamp":1785388588732,"version":"3.55.0"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Depression has a major impact on the disease burden of multiple sclerosis (MS). Analyses of overlapping MS and depression risk factors [smoking, vitamin D (25-OH-VD) and Epstein-Barr virus (EBV) infection] and sex, age, disease characteristics and neuroimaging features associated with depressive symptoms in early MS are scarce. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives:<\/jats:title><jats:p> To assess an association of MS risk factors with depressive symptoms within the German NationMS cohort. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p> Cross-sectional analysis within a multicenter observational study. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Baseline data of n\u2009=\u2009781 adults with newly diagnosed clinically isolated syndrome or relapsing-remitting MS qualified for analysis. Global and region-specific magnetic resonance imaging (MRI)-volumetry parameters were available for n\u2009=\u2009327 patients. Association of demographic factors, MS characteristics and risk factors [sex, age, smoking, disease course, presence of current relapse, expanded disability status scale (EDSS) score, fatigue (fatigue scale motor cognition), 25-OH-VD serum concentration, EBV nuclear antigen-1 IgG (EBNA1-IgG) serum levels] and depressive symptoms (Beck Depression Inventory-II, BDI-II) was tested as a primary outcome by multivariable linear regression. Non-parametric correlation and group comparison were performed for associations of MRI parameters and depressive symptoms. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Mean age was 34.3\u2009years (95% confidence interval: 33.6\u201335.0). The female-to-male ratio was 2.3:1. At least minimal depressive symptoms (BDI-II\u2009&gt;\u20098) were present in n\u2009=\u2009256 (32.8%), 25-OH-VD deficiency (&lt;20\u2009ng\/ml) in n\u2009=\u2009398 (51.0%), n\u2009=\u2009246 (31.5%) participants were smokers. Presence of current relapse [coefficient ( c)\u2009=\u20091.48, p\u2009=\u20090.016], more severe fatigue ( c\u2009=\u20090.26, p\u2009&lt;\u20090.0001), lower 25-OH-VD ( c\u2009=\u2009\u22120.03, p\u2009=\u20090.034) and smoking ( c\u2009=\u20090.35, p\u2009=\u20090.008) were associated with higher BDI-II scores. Sex, age, disease course, EDSS, month of visit, EBNA1-IgG levels and brain volumes at baseline were not. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Depressive symptoms need to be assessed in early MS. Patients during relapse seem especially vulnerable to depressive symptoms. Contributing factors such as fatigue, vitamin D deficiency and smoking, could specifically be targeted in future interventions and should be investigated in prospective studies. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562864231197309","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T12:54:37Z","timestamp":1694177677000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors associated with depressive mood at the onset of multiple sclerosis - an analysis of 781 patients of the German NationMS cohort"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4751-299X","authenticated-orcid":false,"given":"Anke","family":"Salmen","sequence":"first","affiliation":[{"name":"Department of Neurology, St. Josef-Hospital Bochum, Ruhr-University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany"},{"name":"Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0115-7021","authenticated-orcid":false,"given":"Robert","family":"Hoepner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3293-5121","authenticated-orcid":false,"given":"Vinzenz","family":"Fleischer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Heldt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Focus 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