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Alhazzani et al. Neuroimmunol Neuroinflammation 2018;5:8 I http://dx.doi.org/10.20517/2347-8659.2017.55 Page 5 of 10

Table 2. Distribution of respondents by clinical variables
Characteristics Patients (n = 598)
Duration of the disease (years), mean ± SD (range) 6.6 ± 4.8 (0.3-30)
Number of admissions during the last year, n (%)
0 234 (39.1)
1 162 (27.1)
2 90 (15.1)
3 42 (7)
4 16 (2.7)
5 16 (2.7)
> 5 38 (6.4)
Total 598 (100.0)
Patient age at time of diagnosis (years), mean ± SD (range) 26.1 ± 7.9 (0-56)
Number of attacks in the last 2 years, mean ± SD (range) 1.9 ± 2 (0-14)
Family history of MS, n (%)
Yes 58 (9.7)
No 540 (90.3)
Chronic disease, n (%)
No 442 (74.2)
DM 16 (2.7)
HTN 18 (3)
Asthma 28 (4.7)
Depression 16 (2.7)
Thyroid disease 18 (3)
SLE 2 (0.3)
Anti phospholipid syndrome 16 (2.7)
Behjet 0 (0.0)
Headache/migraine 16 (2.7)
Shogren syndrome 2 (0.3)
More than 1 38 (6.4)
Current drug, n (%)
Interferon beta-1b (Betaferon) 146 (26.2)
Interferon beta-1a (Rebif) 114 (20.4)
Interferon beta-1a (Avonex) 102 (18.3)
Copaxone (Glatiramer) 0 (0.0)
Teriflunomide (Aubagio) 20 (3.6)
Dimethyl fumarate (Tecfidera) 18 (3.2)
Fingolimod (Gilenya) 106 (19)
Natalizumab (Tysabri) 46 (8.2)
Mitoxantrone 0 (0.0)
Rituximab (Rituxan) 4 (0.7)
Alemtuzumab (Lemetrada) 2 (0.4)
Have been diagnosed with depression before, n (%)
Yes 164 (27.4)
No 434 (72.6)
Use of anti-depressant drugs, n (%)
Yes 108 (18.1)
No 490 (81.9)
MS: multiple sclerosis; DM: diabetes mellitus; HTN: hypertension; SLE: systemic lupus erythematosus

Relation between patients’ received medications and depression
The severity of depression differed significantly according to received medications (P < 0.001). All patients
who received alemtuzumab had severe depression (2, 100%). Moreover, the highest percentages of moderately
severe and severe depression were observed among those who received interferon beta-1a (21.1% and 14%,
respectively) and dimethyl fumarate (DMF) (22.2% and 11.1%, respectively) [Table 6].

Relation between patients’ level of disability and depression
There was a significant association between patients’ level of disability and severity of depression (P < 0.001). It is
to be noted that none of the patients with absent depression had a moderate or severe disability, while those
with moderately severe or severe depression had their highest percentages of severe disability (35.3% and
23.5%, respectively) [Table 6].