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Systematic Review: Mental Health Outcomes in Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating
Cathy Meng Fei Li1, Stanley Wong2, Nicholas Fabiano3
1Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
Background:
Patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) have mental health sequelae that impact their quality of life. The burden of mental health disorders in these patients is poorly established.
Aim:
To review the literature on the frequency and risk of mental disorders in GBS and CIDP.
Methods:
A systematic review was conducted to identify primary studies that reported mental health outcomes in patients with GBS and CIDP. Screening, full-text review, data extraction and quality assessment were performed in duplicate, with discrepancies resolved by a third party.
Results:
This systematic review included 19 studies. Three studies reported mental health diagnoses using the International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders criteria: up to 82%, 67%, 25% and 22% of patients following GBS were diagnosed with anxiety, depression, brief reactive psychosis and post-traumatic stress disorders, respectively. The risk of anxiety disorders following GBS normalized after 3 months, but the risk of depressive disorders remained elevated for 2 years. Although 30%-50% of patients with CIDP described mental health symptoms, no studies reported mental health diagnoses. Active disease and neuropathic pain were associated with more depressive symptoms in patients with CIDP.
Conclusion:
Many patients following GBS or with active CIDP experience symptoms that may fulfill the criteria for mental health diagnoses, but the paucity of literature suggests that mental health disorders are underdiagnosed and undertreated in this population. These patients are at higher risk of developing mental health disorders, thereby emphasizing the need for timely mental health care and assessment of their disease-specific risk factors.
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