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Major depressive disorder subtypes and depression symptoms in multiple sclerosis: What is different compared to the

Stephanie Rodgers1, Pasquale Calabrese2, Vladeta Ajdacic-Gross3

  • 1Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland.

Journal of Psychosomatic Research
|February 25, 2021
PubMed
Abstract

Insights

Major depressive disorder (MDD) in persons with multiple sclerosis (PwMS) shows a higher risk for the mixed atypical-melancholic subtype and specific somatic symptoms like weight gain and leaden paralysis. Pure atypical MDD did not differ between PwMS and persons without MS.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Major Depressive Disorder (MDD) is a common comorbidity in Multiple Sclerosis (MS).
  • Understanding MDD subtypes and symptoms in persons with MS (PwMS) is crucial for accurate diagnosis and treatment.
  • Previous research has not fully characterized the specific phenotypic presentations of MDD in PwMS.

Purpose of the Study:

  • To compare and characterize MDD subtypes and depression symptoms in PwMS versus persons without MS (Pw/oMS).
  • To identify specific depression symptom profiles associated with MDD in PwMS.
  • To empirically identify depression subtypes in PwMS using latent class analysis.

Main Methods:

  • Comparison of MDD in 92 PwMS from the Swiss Multiple Sclerosis Registry with 277 Pw/oMS from a community-based study.
  • Epidemiological MDD diagnoses using the Mini-SPIKE.
  • Logistic, multinomial regression, and latent class analyses adjusted for relevant covariates.

Main Results:

  • PwMS had a significantly higher risk for the mixed atypical-melancholic MDD subtype (OR=2.22).
  • MDD in PwMS was characterized by increased risk of somatic atypical symptoms: 'weight gain' (OR=6.91) and 'leaden paralysis' (OR=3.03), and 'irritable/angry' (OR=3.18).
  • The pure atypical MDD subtype did not differentiate between PwMS and Pw/oMS.

Conclusions:

  • MDD in PwMS is marked by a higher prevalence of the mixed atypical-melancholic subtype and specific somatic atypical symptoms.
  • The pure atypical MDD subtype is not a distinguishing feature of MDD in PwMS.
  • The mixed atypical-melancholic MDD subtype presents a diagnostic challenge in PwMS due to phenomenological overlap with MS symptoms.
Keywords:
DepressionMultiple sclerosisSubtypes

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