Psychiatric Conditions Other Than Depression Common in Multiple Sclerosis Patients: Presented at ENS
By Norra MacReady
LAUSANNE, SWITZERLAND -- June 1, 2006 -- Contrary to conventional wisdom, depression is not necessarily the most common neuropyschiatric disorder observed in people with multiple sclerosis (MS), according to a poster presentation at the 16th Annual Meeting of the European Neurological Society (ENS).
It has been estimated that depression occurs in 40% of the MS patient population. The overall prevalence of some type of cognitive or neuropsychiatric impairment is thought to be 60% to 70%, and is produced by a combination of emotional factors and the central nervous system effects of the disease.
However, hard data confirming or disputing these estimates are scarce. Therefore, investigators led by Sara Pires-Baranta, PsyD, neuropsychologist, Hospital do Espirito Santo, Evora, Portugal, studied the neuropsychiatric symptoms in their MS patients.
Between 2001 and 2005, these researchers followed 40 women and 28 men who had been diagnosed with MS at least 6 months previously. The patients, who ranged in age from 17 to 60 years, provided basic information about themselves, including type of MS, age at diagnosis, and treatment.
Patients also completed the Symptom Checklist 90 (SCL 90), a 90-item clinical rating instrument of psychopathology that can serve as both a screening test and as a measure of patient progress. The checklist is divided into 9 subscales, each designed to ferret out information about a different condition, such as depression, obsessive-compulsive disorder, anxiety, hostility, and paranoia. "This is a good test, because it also lets us evaluate symptom severity," Dr. Pires-Baranta said.
Of the 68 patients, 72% had the relapsing-remitting form of MS, and 30% had been diagnosed when they were 30 to 40 years old. On the SCL-90, many patients had symptoms of multiple psychiatric conditions.
Sleep disorders occurred in 82% of the patients. Significant obsessive-compulsive symptoms were seen in 75%, and 67% had some form of eating disorder.
Depression was present in 61%, so it exceeded many experts' estimates even if it was not the most common single condition in this study, Dr. Pires-Baranta said. Anxiety occurred in 43% and 57% of patients had somatization symptoms.
There was no relationship between any neuropsychiatric symptoms and disease variables such as stage of illness, age of onset, or duration or disease.
"Our findings suggest that depression may not be the most common neuropsychiatric condition in MS patients, even though it is often described that way," Dr. Pires-Baranta concluded.
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