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Depression and Multiple Sclerosis: Clinical Aspects, Epidemiology, and Management

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Neuropsychiatric Symptoms of Inflammatory Demyelinating Diseases

Part of the book series: Neuropsychiatric Symptoms of Neurological Disease ((NSND))

Abstract

Multiple sclerosis (MS) is associated with a broad array of neuropsychiatric problems of which depression is the commonest. Defining depression can present a potential problem because certain symptoms that underpin the diagnosis of depression may also be caused by multiple sclerosis. Certain self-report scales that take this symptom overlap into account have been validated for MS patients (Beck Fast Screen for Medical Patients and the Hospital Anxiety and Depression Scale). MS-related major depression has a lifetime prevalence of 25–50 %, well above the rate in the general population. Depression is linked to a poor quality of life, potentially greater cognitive impairment, an increase in suicidal ideation, and less compliance with disease-modifying drugs. Notwithstanding the high prevalence of depression in MS and its multiple adverse effects on the MS population, there are only two randomized trials of antidepressant medication (paroxetine and desipramine). Results are modest and side effects can be troubling. Treatment of choice is therefore cognitive behavioral therapy. Mindfulness-based therapy and exercise may also offer benefits to the depressed MS patient.

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Author information

Authors and Affiliations

  1. Neurology Department, CHU Bicêtre, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France

    Marie Théaudin MD, Ph.D.

  2. Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

    Anthony Feinstein MD, M.Phil., Ph.D., FRCP

Authors
  1. Marie Théaudin MD, Ph.D.
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  2. Anthony Feinstein MD, M.Phil., Ph.D., FRCP
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Correspondence to Anthony Feinstein MD, M.Phil., Ph.D., FRCP .

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Editors and Affiliations

  1. Department of Neurology, Centre Hospitalier Universitaire Pellegrin, INSERM U 862, Université de Bordeaux, Bordeaux, Gironde, France

    Bruno Brochet

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Théaudin, M., Feinstein, A. (2015). Depression and Multiple Sclerosis: Clinical Aspects, Epidemiology, and Management. In: Brochet, B. (eds) Neuropsychiatric Symptoms of Inflammatory Demyelinating Diseases. Neuropsychiatric Symptoms of Neurological Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-18464-7_2

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  • DOI: https://doi.org/10.1007/978-3-319-18464-7_2

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18463-0

  • Online ISBN: 978-3-319-18464-7

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