Article title: Depression and Sub-clinical Markers of Multiple Sclerosis

Multiple sclerosis (MS) is a chronic neurological disease that depression has been found in more than 40% of patients and due to a number of sub-clinical markers associated with disease the opportunity to the emergence of gains. The purpose of this study was to assess depression and markers of sub-clinical multiple sclerosis. In this analytical cross-sectional study, 162 patients with MS were selected by consecutive sampling and using the clinical and demographic variables inventory, Depression, Anxiety and Stress Scale, Short Form Health Survey questionnaire, and Fatigue Severity Scale along with identical analog-spring balance were examined. Data were analyzed using Pearson's correlation coefficient, one-way ANOVA, Tukey's test and stepwise multiple regression. Patients with 3 or more times of frequency and hospitalizations were experiencing received a significantly higher depression scores than patients with lower frequency of hospitalization. in addition to the markers of sub-clinical disease 30% of the common variance in depression could explained totaly. Generally in the final step due to limitations of physical problems, bodily pain, fatigue the depression scores in patients were able to be predicted significantly (p <0.0001). The impacts of sub-clinical markers in multiple sclerosis patients with depression were significant. Therefore it is necessary that the key predictors identified in this study were known as a possible predisposing factor in the development of depression associated with multiple sclerosis be exploited to manage the disease regularly.