OBJECTIVES: Myasthenia Gravis (MG) is a rare and chronic autoimmune disease characterized by fluctuating and rapid muscle weakness and fatigue. People living with MG can be limited in their daily activities and may experience increased psychological symptoms due to reduced quality of life, disease and treatment burden. The objective of the analysis was to understand the prevalence of depression and anxiety as well as their associated risk factors.

METHODS: The Myasthenia Gravis Foundation of America (MGFA) Global MG Patient Registry (MGFAPR) is an online longitudinal patient reported registry hosted on the Health Storylines platform. A cross-sectional retrospective study was conducted with enrollment surveys of MGFAPR from November 2017 and March 2022. Participants were 18 years of age and above, with a self-reported diagnosis of MG. Those with incomplete responses to Myasthenia Gravis Activities of Daily Living Scale (MG-ADL) or Myasthenia Gravis Quality of Life 15-item Scale – Revised (MG-QoL-15r) were excluded (n= 4). In addition to descriptive statistics, gender differences were assessed using t-test and Chi-square tests (or Fisher’s exact test). Potential factors associated with self-reported diagnosis of anxiety and depression were evaluated individually using logistic regression.

RESULTS: The study included 1,774 MG patients (1,046 females and 728 males). The prevalence of depression and anxiety were 33.7% and 34.4% respectively. The prevalence was higher in females in comparison to males in both depression (40.4% vs 24%, p<0.001) and anxiety (41.2% vs. 24.6%, p<0.001). Self-reported symptom severity of both conditions was also higher in females than males. Lower income, female gender, unemployment, higher MG-ADL scores were significant risk factors for both psychological disorders.

CONCLUSIONS: Approximately one third of the people living with MG suffer from depression and anxiety. MG patients, particularly those with elevated risk, can benefit from holistic care that addresses anxiety and depression in addition to the physiologic effects of MG.