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High-dose corticosteroids (HDC) may worsen mood in multiple sclerosis (MS) patients, particularly those with pre-existing bipolar symptoms. Screening for mood disorders before HDC is crucial for safe MS treatment.

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Area of Science:

  • Neurology
  • Psychiatry
  • Clinical Pharmacology

Background:

  • High-dose corticosteroids (HDC) are standard for multiple sclerosis (MS) relapses.
  • Reports suggest HDC increases psychiatric disorder risk in MS patients.

Purpose of the Study:

  • To investigate HDC's impact on mood in MS patients.
  • To identify factors influencing mood changes post-HDC.

Main Methods:

  • 101 MS patients assessed before, during, and after HDC.
  • Beck Depression Inventory-Second Edition (BDI-II) for depression.
  • Mood Disorder Questionnaire (MDQ) for bipolar symptoms.

Main Results:

  • 31.7% had baseline depressive symptoms; 19.8% had bipolar symptoms.
  • BDI-II scores decreased post-HDC.
  • MDQ scores increased in patients with baseline MDQ positivity, linked to more HDC infusions (p=0.018).

Conclusions:

  • Pre-HDC screening for mood disorders in MS patients is vital.
  • Exercise caution with HDC in MS patients with MDQ positivity.