Neuropsychiatric Manifestations of Multiple Sclerosis

Abstract

The range of neuropsychiatric symptoms in multiple sclerosis (MS) has not been prospectively assessed. The authors, working at a tertiary medical center in Mexico City, used the Neuropsychiatric Inventory (NPI) to evaluate neuropsychiatric symptoms prospectively in 44 MS patients who were stable between relapses and 25 control subjects of similar age, education, and cognitive function. Neuropsychiatric symptoms were present in 95% of patients and 16% of control subjects. Changes present were depressive symptoms (79%), agitation (40%), anxiety (37%), irritability (35%), apathy (20%), euphoria (13%), disinhibition (13%), hallucinations (10%), aberrant motor behavior (9%), and delusions (7%). The only relationships with MRI were between euphoria and hallucinations and moderately severe MRI abnormalities. The authors conclude that diverse types of neuropsychiatric symptoms are common in MS; symptoms are present between exacerbations; and there are variable correlations with MRI abnormalities.

Psychiatric manifestations of multiple sclerosis and acute disseminated encephalomyelitis

“…Diaz-Olavarrieta et al [7] evaluated 44 MS patients who were stable between relapses and found neuropsychiatric symptoms in 95% of them, the most common being depression (79%), agitation (40%), anxiety (37%), irritability (35%), apathy (20%), euphoria (13%), disinhibition (13%), hallucinations (10%), aberrant motor behavior (9%), and delusions (7%). Asghar-Ali et al [8] described two patients, without a previous history of psychiatric disorders, were first thought to have bipolar disorder, but were diagnosed as MS after brain MRI and CSF examinations.…”

Le processus de construction de sens dans l’adaptation à la sclérose en plaques

“…Les travaux de plusieurs chercheurs témoignent entre autres d'un risque suicidaire accru ainsi que d'une association de la maladie avec les troubles dépressifs, anxieux, bipolaires et psychotiques (Beiske et al, 2008;Diaz-Olavarrieta, Cummings, Velazquez, & Garcia de al Cadena, 1999;Korostil & Feinstein, 2007;Patten, Svenson, & Metz, 2005;Turner, Williams, Bowen, Kivlahan, & Haselkom, 2006). La SEP a aussi une incidence certaine entre autres sur l'employabilité ainsi que sur les relations familiales.…”

“…Les manifestations de l'anxiété en lien avec la SEP font l'objet d'un plus faible nombre d'études, mais elles ont été diagnostiquées chez 44,3 % d'un échantillon français (Chahraoui et al, 2008), chez 37 % de patients d'une clinique SEP au Mexique (Diaz-Olavarrieta et al, 1999) et chez près de 20 % d'un échantillon norvégien (Beiske et al, 2008). La prévalence de l'anxiété est de 37,5 % à vie et de 14 % au moment d'une étude effectuée auprès d'un échantillon canadien de personnes atteintes de SEP (Korostil & Feinstein, 2007).…”

Novel Antipsychotics in the Treatment of Behavioral Disturbances and Psychoses Associated With Neurodegenerative Disorders

“…It usually becomes evident in patients in their 20s or 30s. Depression, mania, and psychotic symptoms are common neuropsychiatric sequelae [63][64][65] and may result from the interruption of the integrity of frontotemporal circuits by demyelinating lesions. Psychoses can occur in patients with MS, and treatment of these psychoses is probably warranted.…”