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Psychiatric Disorders, Stress, and Their Treatment Among People with Multiple Sclerosis

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Psychological Co-morbidities of Physical Illness

Abstract

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) affecting 400,000 people in the United States and 2.5 million worldwide. Numerous psychiatric disorders are likely more prevalent among people with MS than the general population, most notably depression, anxiety, and possibly bipolar disorders. Most of research to date has focused on depression. The increased prevalence of depression may be due to MS pathogenic factors, such as inflammation, and MS pathology including lesion volume in specific frontal, temporal, and/or parietal brain regions. Other factors that commonly contribute to depression, such as genetic predisposition and psychosocial factors, may also contribute to depression in MS, but it is unclear if they account for the greater prevalence of psychiatric disorders and distress. This chapter also reviews the growing body of evidence indicating that an association between stress and exacerbation exists and discusses possible mechanisms underlying this association. Finally, the trials examining the efficacy of pharmacotherapy and psychotherapy for the treatment of depression in MS are reviewed. In general, the evidence suggests that people with MS can respond to pharmacotherapeutic and psychotherapeutic interventions.

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  1. Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, 680 N. Lakeshore Drive, Suite 1220, Chicago, IL, 60611, USA

    David C. Mohr PhD

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  1. Medical School, Div. Preventive & Behavioral Medicine, University of Massachusetts, N. Lake Ave. 55, Worcester, 01655, Massachusetts, USA

    Sherry Pagoto

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Mohr, D.C. (2011). Psychiatric Disorders, Stress, and Their Treatment Among People with Multiple Sclerosis. In: Pagoto, S. (eds) Psychological Co-morbidities of Physical Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0029-6_8

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