Utility, validity and acceptability of survey depression and anxiety screening tools for routine multiple sclerosis clinic administration

BACKGROUND: Depression and anxiety are often undetected and untreated in individuals with multiple sclerosis (MS), despite a high prevalence of these conditions in this population. This study evaluated the clinical utility, diagnostic accuracy, and acceptability of depression and anxiety screeners and their integration into routine MS clinic appointments. METHODS: Participants with MS (N = 207; age M = 47.3 ± 12.7 years, 77.3% female) were enrolled in this cross-sectional study conducted at an MS clinic in Melbourne, Australia. Consenting participants completed the Patient Reported Questionnaire-9 (PHQ-9) and the Depression, Anxiety and Stress Scale-21 (DASS-21) via an electronic tablet in the clinic waiting room or online for telehealth appointments, and underwent a Structured Clinical Interview for DSM-5 major depressive disorder and generalised anxiety disorder. Sensitivity, specificity, internal consistency, and patient comfort were assessed. RESULTS: The PHQ-9 and DASS-21 depression subscales demonstrated excellent internal consistency (α=0.90-.93) and good diagnostic performance. For anxiety, DASS subscales showed moderate validity, with the stress subscale outperforming the anxiety subscale. Participants rated screening as highly acceptable (mean comfort score=7.7/10). CONCLUSIONS: Among people with MS, self-administered depression and anxiety screening tools are valid and acceptable for routine use at MS clinic appointments. Tablet and online survey administration provide scalable options for integrating mental health assessment into standard care.