Abstract-Depression is the most frequent psychiatric disorder in multiple sclerosis (MS) patients. The etiology of depression is multifactorial and likely associated with psychosocial stress, focal demyelinating lesions, and immune dysfunction. Proper diagnosis and severity assessment are critical prior to initiation of therapy. Patients with suicidal ideation should be referred for immediate psychiatric consultation and be closely monitored. While more therapeutic trials for depression in MS are needed, MS patients have been shown to respond to current antidepressant medications and psychotherapy. Unfortunately, patients with MS and major depression or suicidal thoughts are often underassessed and therefore not diagnosed. Unlike other aspects of MS, depression is treatable. Early intervention in depression can prevent declines in quality of life and even death from suicide. This article reviews the unique features, assessment, and treatment of depression in MS. MS care providers should vigilantly assess depression and suicide risk in their patients.

In this article we review studies in which Automated Neuropsychological Assessment Metrics (ANAM) measures were used to screen for impairment in various clinical populations. These clinical groups include patients with multiple sclerosis, systemic lupus erythematosus, Parkinson's disease, Alzheimer's dementia, acquired brain injury, and migraine headache. Data are also presented from a group of outpatient referrals unselected with respect to clinical condition. Findings support the use of ANAM as a screening procedure for identifying the impaired patient.

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Prospective memory (PM), which is the ability to remember to carry out actions that are planned for the future, plays an important role in professional and social life as well as in activities of daily living. This study examined PM performance among adults with multiple sclerosis (MS) and evaluated the efficacy of a mnemonic strategy, implementation intentions. Compared to controls, adults with MS were impaired on PM, both in terms of acting when encountering the correct circumstances (prospective component) and in terms of remembering the correct action to perform (retrospective component). The prospective-component deficit was greater for tasks that depended on more resource-demanding cognitive processes and smaller on tasks that could be performed more automatically. Use of implementation intentions improved MS-group performance on the prospective component, particularly on the more resource-demanding tasks, consistent with the explanation that implementation intentions improved performance by allowing the use of more automatic processes to perform these PM tasks. Implications for providing environmental support to encourage the use of mnemonic strategies are discussed.

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