Multiple sclerosis and affective disorder: 2 case reports of mania with psychosis

Multiple sclerosis and affective disorder are both diseases that wax and wane as well as have variable clinical symptomatology. Their common co-occurrence has given rise to intense speculation about their etiological and clinical connection. In this paper, 2 case reports and discussions are presented, and a pertinent review of the literature is included concerning the question whether affective symptomatology is the direct result of, a reaction to, or coexistent with, the neurological disease process. The specific cataloguing of affective symptoms with multiple sclerosis is suggested as possibly being helpful in warning clinicians as to the presence of multiple sclerosis. The rhythmicity of both illnesses is briefly discussed in the light of recent literature on circadian rhythms.