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Depression associated with multiple sclerosis. Looking beyond diagnosis to symptom expression
1Department of Psychiatry, Sunnybrook and Women's Health Science Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. ant.feinstein@utoronto.ca
Journal of Affective Disorders
|October 2, 2001
Summary
Emotional dyscontrol in multiple sclerosis (MS) patients, even without a formal diagnosis, significantly increases psychological distress. Early detection and treatment of these affective instability symptoms are crucial for reducing MS-related morbidity.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Multiple sclerosis (MS) patients face a high risk of major depression.
- Sub-syndromal affective instability (irritability, sadness, tearfulness) in MS is understudied.
- The impact of emotional dyscontrol on psychological distress in MS requires further investigation.
Purpose of the Study:
- To assess the prevalence of major depression and emotional dyscontrol in MS patients.
- To determine the relationship between emotional dyscontrol and psychological distress in MS.
- To evaluate the clinical significance of sub-syndromal affective instability in MS.
Main Methods:
- 100 out-patients with definite MS were evaluated.
- Assessments included the Structured Clinical Interview for DSM-IV (SCID-1) for major depression.
- Pathological Laughing and Crying Scale (PLACS), Beck Depression Inventory (BDI), and General Health Questionnaire (GHQ) were used.
Main Results:
- 17% of MS patients were diagnosed with major depression.
- 8% experienced pathological laughing and crying (PLC).
- 48% exhibited emotional dyscontrol without meeting formal psychiatric criteria.
- Emotional dyscontrol and major depression were significantly linked to higher psychological distress (GHQ scores ≥5).
Conclusions:
- Sub-syndromal emotional dyscontrol in MS is common and associated with significant psychological distress.
- Clinicians should address symptoms like irritability and sadness, even if they don't meet diagnostic criteria.
- Early detection and pharmacotherapy for affective instability can reduce MS-related morbidity.