Depression Treatment among Adults with Multiple Sclerosis and Depression in Ambulatory Care Settings in the United States

Bhattacharjee, Sandipan; Goldstone, Lisa; Ip, Queeny; Warholak, Terri

doi:10.1155/2017/3175358

Cited by 16 publications

(10 citation statements)

References 31 publications

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“…24 Additionally, untreated depression in multiple sclerosis may increase the risk of suicide. 25 The results of the present study reveal a high prevalence of depression among patients with multiple sclerosis in Erbil city, which is about 53.5%; this is close to several previous studies that shown to be around 50%. 11 Depending on the diagnostic criteria and sample size that had been used, the prevalence of depression ranges from 19 to 54%.…”

Section: Mild Moderate Severesupporting

confidence: 89%

Prevalence of depression among patients with multiple sclerosis in Erbil city

Sulaiman

Ali

2020

Zanco J. Med. Sci.

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Multiple sclerosis (MS) is one of the central nervous system (CNS) diseases, which is chronic, inflammatory, and immune-mediated, typically presents in the third or fourth decade of life. 1,2 It is one of the most frequent nontraumatic disabling neurologic diseases, which affects 12,000 people in the United States alone per year. 3 There is high variability in the disease course. Its outcome is hard to predict, with no known cure. 4 Patients may be grouped into four categories; Relapsing-remitting (RR) MS, Secondary progressive (SP) MS, Primary progressive (PP) MS, and Progressive-relapsing (PR) MS, based on the course of the disease. 5 Nearly 87% of patients are of RRMS type, characterized by acute attacks (relapses) followed by partial or full recovery (remission). There are a heterogeneous group of symptoms, including changes in vision (unilateral visual loss, diplopia), weakness, incoordination, sensory loss or distortions, or changes in bowel and bladder function, cognitive change, fatigue, and mood disturbance. 6 Multifocal involvement of white and gray matter in the central nervous system can cause physical impairment and disability, with cognitive and psychological changes that often lessen patients' quality of life, occupational competence, and social interactions. 7 Psychiatric comorbidity is common in Background and objective: Multiple sclerosis is one of the chronic central nervous system diseases. Depression comorbidity is common with multiple sclerosis. This study aimed to determine the prevalence of depression among patients with multiple sclerosis and the relation of patient demographic data and disease status. Methods: A cross-sectional study was conducted in Rizgary Teaching Hospital in Erbil City, in a one-year duration from October 2017 to October 2018. The sample size was 169 known patients with multiple sclerosis, which was collected randomly. Beck Depression Inventory was used. The statistical package for the social sciences (version 25) was used for data analysis. Pearson Chi-square and Fisher's Exact Test were used to finding the association between various variables and depression. Results: The prevalence of depression among patients with multiple sclerosis was 53.5%. Age group more than 50 years was found more depressed (66.7 %,P = 0.006). Depression is more with those with multiple sclerosis for 10 years and more (84.6%) with a statistically significant association (P = 0.021). Treatment by rituximab show more depression (85.7%,P = 0.039). The frequency of severity of major depressive disorder was (mild 31.8%, moderate 52.9%, and severe 15.3%) and showed no significant association with different variables. Conclusion: The prevalence of depression among patients with multiple sclerosis was high. The age group of more than 50 years, duration of multiple sclerosis equal or more than 10 years, and rituximab treatment were regarded as risk factors.

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Section: Mild Moderate Severesupporting

confidence: 89%

Prevalence of depression among patients with multiple sclerosis in Erbil city

Sulaiman

Ali

2020

Zanco J. Med. Sci.

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“…Impaired neuronal function (1–4), from neuroinflammation or other causes, is a known driver of depression and related neuropsychiatric problems (5–11) that often accompany complex CNS disorders, including TBI (12, 13) and CNS disorders with autoimmune components (14), such as multiple sclerosis (MS) (15, 16), Parkinson’s disease (PD) (17–19), and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS)/Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) (20). A recent twin study by Huang, et al, suggests that the causal connection between depression and neuroinflammation may be bidirectional.…”

Section: Introductionmentioning

confidence: 99%

Microglial Phagocytosis of Neurons: Diminishing Neuronal Loss in Traumatic, Infectious, Inflammatory, and Autoimmune CNS Disorders

Yanuck

2019

Front. Psychiatry

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Errors in neuron-microglial interaction are known to lead to microglial phagocytosis of live neurons and excessive neuronal loss, potentially yielding poorer clinical outcomes. Factors that affect neuron-microglial interaction have the potential to influence the error rate. Clinical comorbidities that unfavorably impact neuron-microglial interaction may promote a higher rate of neuronal loss, to the detriment of patient outcome. This paper proposes that many common, clinically modifiable comorbidities have a common thread, in that they all influence neuron-microglial interactions. Comorbidities like traumatic brain injury, infection, stress, neuroinflammation, loss of neuronal metabolic integrity, poor growth factor status, and other factors, all have the potential to alter communication between neurons and microglia. When this occurs, microglial phagocytosis of live neurons can increase. In addition, microglia can shift into a morphological form in which they express major histocompatibility complex II (MHC-II), allowing them to function as antigen presenting cells that present neuronal debris as antigen to invading T cells. This can increase risk for the development of CNS autoimmunity, or can exacerbate existing CNS autoimmunity. The detrimental influence of these comorbidities has the potential to contribute to the mosaic of factors that determine patient outcome in some CNS pathologies that have neuropsychiatric involvement, including TBI and CNS disorders with autoimmune components, where excessive neuronal loss can yield poorer clinical outcomes. Recognition of the impact of these comorbidities may contribute to an understanding of the common clinical observation that many seemingly disparate factors contribute to the overall picture of case management and clinical outcome in these complex disorders. In a clinical setting, knowing how these comorbidities can influence neuron-microglial interaction can help focus surveillance and care on a broader group of potential therapeutic targets. Accordingly, an interest in the mechanisms underlying the influence of these factors on neuron-microglial interactions is appropriate. Neuron-microglial interaction is reviewed, and the various mechanisms by which these potential comorbidities influence neuro-microglial interaction are described.

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“…A study in Canada (2018) showed 30% of MS patients suffered from anxiety and 16.3% were affected with depression. Anxiety, depression, and stress are negative loads of MS that have negative effects on the quality of life of the patients [11]. Another study in Italy (2011) indicated 43.0% of MS patients suffered from anxiety and 34% suffered from depression [8].…”

mentioning

confidence: 99%

Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study

2020

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Background: Multiple sclerosis (MS) is a chronic disease that decreases the physical ability and affects the mental health of the patients. This descriptive-analytical study investigated the prevalence of depression, anxiety and stress in MS patients. Methods: A total of 87 MS patients were recruited in this study through simple random sampling method using a random number table. Data were collected by Depression, Anxiety, and Stress Scale-21 (DASS-21) and analyzed by descriptive and analytical statistics. Results: The mean age of the patients was 35.5 ± 9.2 years. Of them, 41 (47.1%) had moderate depression, 34 (39.1%) had moderate anxiety, and 39 (44.8%) had moderate stress. There was a significant relationship between depression and job, education, and economic status of the participants. There was also a significant association between the participants' economic status and anxiety. There was no significant relationship between stress and any of the variables. Conclusion: Given the relatively high prevalence of anxiety, depression, and stress in MS patients as well as the significant relationship between their economic status and depression and anxiety, interventional measures are required to be taken to decrease their problems and to provide a favorable ground for their employment. Periodic examinations by psychologists / psychiatrists and treatment of patients with symptoms of stress, anxiety and depression are also essential.

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Depression Treatment among Adults with Multiple Sclerosis and Depression in Ambulatory Care Settings in the United States

Cited by 16 publications

References 31 publications

Prevalence of depression among patients with multiple sclerosis in Erbil city

Prevalence of depression among patients with multiple sclerosis in Erbil city

Microglial Phagocytosis of Neurons: Diminishing Neuronal Loss in Traumatic, Infectious, Inflammatory, and Autoimmune CNS Disorders

Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study

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