TOPLINE:

Depressive symptoms, alongside disease severity and age, were significantly associated with higher total costs of illness in patients with neuromyelitis optica spectrum disorders (NMOSD); however, pain showed no independent association with total costs despite its high prevalence.

METHODOLOGY:

• Researchers conducted a cross-sectional questionnaire-based study to evaluate the role of depression and pain in patients with NMOSDs on all types of costs from a societal perspective.
• They included 115 patients (median age, 53 years; 85% women) with a confirmed NMOSD according to the International Panel for NMO Diagnosis 2015 criteria across 12 centres of the Neuromyelitis Optica Study Group in Germany between 2017 and 2019.
• The total annual cost of illness from a societal perspective was assessed using a detailed questionnaire covering direct medical costs, direct non-medical costs, and indirect costs, calculated in euros for the year 2018.
• Pain was assessed using the short form of the Brief Pain Inventory based on a numeric rating scale ranging from 0 (no pain) to 10 (worst imaginable pain), capturing pain severity and interference with daily life reported within the last week.
• Depressive symptoms were evaluated using the Beck Depression Inventory-II (score range, 0-63).

TAKEAWAY:

• Overall, 77% of patients suffered from chronic NMOSD-related pain, with a median pain intensity of 4.0, and 23% reported no NMOSD-related pain.
• Moderate or severe depressive symptoms were reported by 19% of patients, minimal or mild depressive symptoms were reported by 37%, and no depressive symptoms were reported by 44%.
• Increasing depressive symptoms along with the severity of the disease and age were independently associated with a rising total cost of illness (P < .05 for all); pain was not significantly linked to the total cost of illness.
• The increase in the cost was driven by informal care costs (care provided by untrained personnel such as relatives or friends), rising from approximately €10,133 per patient per year in those without depressive symptoms to €42,291 per patient per year in those with severe depression.

IN PRACTICE:

"This study highlights the significant economic impact of depression among NMOSD patients, particularly in relation to informal care costs. Beyond confirming the high prevalence of depression in this population, our findings emphasise its role as a major cost driver," the authors wrote.

"Routine screening for depression and treatment needs should be integrated into clinical assessments of NMOSD patients," they added.

SOURCE:

This study was led by Daria Tkachenko, Hannover Medical School, Hanover, and Ilya Ayzenberg, Ruhr University Bochum, St Josef Hospital, Bochum, both in Germany. It was published online on May 04, 2026, in Neurological Research and Practice.

LIMITATIONS:

The cross-sectional design of the study restricted causal inferences. Socioeconomic data were self-reported, which may have introduced recall bias. Additionally, the study did not assess the important contributors of depressive symptom severity such as sleep disorders and fatigue.

DISCLOSURES:

This study received support through a grant from the German Federal Joint Committee/Innovation Fund. Several authors declared receiving honoraria/speaker honoraria, consulting and/or speaker honoraria, travel grant/supports, and/or compensation for serving on a scientific advisory board or serving as a member of a steering committee from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.