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Anxiety and Multiple Sclerosis

  • Chapter
Neuropsychiatric Symptoms of Inflammatory Demyelinating Diseases

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

Abstract

Normal worry and fear are largely adaptive, pervading anxiety is considered maladaptive and, in its various forms, it can characterize clinical disorders. Anxiety levels and anxiety disorders are more frequent in MS patients than in general population; nevertheless, they are overlooked and undertreated. The increase of anxiety in MS patients, more frequent in women than in men, seems related mainly to the diagnostic work-up period and prognostic uncertainties; the groundless fear of becoming rapidly wheelchair dependent plays some role. Exacerbations are also related to anxiety increase, while anxiety decreases as time elapses after the diagnosis and in the remitting phase. Anxiety levels have been studied in relationship with many other variables of interest in MS patients. The outcome of anxiety, the role of coping strategies, and other aspects are of support to the reactive nature of pathological anxiety. Few studies have investigated possible organic contributors, mainly with negative results. Several studies show how high levels of anxiety are associated with low health-related quality of life and decreased performance of some cognitive functions. Unfortunately, some of the available studies have important limitations (e.g., small samples, retrospective collection of data, exclusion of some subjects). In the matter of treatment, randomized controlled trials assessing pharmacologic and non-pharmacologic therapies for anxiety in MS showed inconsistent results. An important effort in covering the existing gaps, particularly about assessment and treatment of anxiety in MS patients, seems timely and relevant.

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Authors and Affiliations

  1. Neurology and NeuroRehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina 306, Rome, 00179, Italy

    Giuseppe Magistrale MSc & Ugo Nocentini MD

  2. Department of Systems Medicine, University of Rome “Tor Vergata”, Via Ardeatina 306, Rome, 00179, Italy

    Ugo Nocentini MD

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  1. Giuseppe Magistrale MSc
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  2. Ugo Nocentini MD
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Correspondence to Ugo Nocentini MD .

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

    Bruno Brochet

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Magistrale, G., Nocentini, U. (2015). Anxiety and Multiple Sclerosis. 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_4

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