Prediction of comorbid depression in patients with disseminated sclerosis of residents in the northern region

Abstract

The mechanism of development of neuropsychological disorders and the assessment of predictors of their development in patients with multiple sclerosis (MS) are insufficiently studied. Prediction of comorbid depression in this category of patients is of great interest and is aimed at personalized medical care for patients with optimal personal and environmental adaptation of the patient with MS. Objective. To study the predictors of the development of depressive syndrome and to develop a mathematical model for predicting comorbid depression in patients with multiple sclerosis living in the northern region. Material and methods. A standard neurological examination was conducted in 149 patients with reliable MS who lived in the northern region, including an assessment of the severity of MS disability on the EDSS scale. All patients underwent neuroimaging (magnetic resonance imaging — MRI) of the brain and spinal cord. The Beck Depression Scale was used to identify depressive disorders. Results. The prevalence of depressive disorders in patients with MS in the studied population of patients in the northern region was 35%. In terms of severity, the identified comorbid depression ranged from subdepression to moderate depression. According to the results of the study, it can be stated that the predictors of the development of comorbid depressive disorders in MS are signs of brain atrophy; chronic intoxication (tobacco smoking and alcohol abuse); foci of demyelination (the semi-oval center, corpus callosum); neurological symptoms in the form of paresis, paralysis, cerebellar symptoms (nystagmus); presence of frontal dysfunction (phonetic associations, selection reactions simple and complicated). Conclusion. Comorbid depressive manifestations in MS patients living in the northern region occur in 35% of patients and are a multidisciplinary problem. In order to reduce the effect of depressive manifestations on the main symptoms of the disease, adherence to therapy and improve the quality of life indicators in patients with MS, it is necessary to influence neurological symptoms and psychological state, paying special attention to the prevention of depression in these patients.