Affective disorders and multiple sclerosis: a controlled study on 65 Italian patients

  • A. Salmaggi
  • R. Palumbo
  • L. Fontanillas
  • M. Eoli
  • L. La Mantia
  • A. Solari
  • D. Pareyson
  • C. Milanese


A high prevalence of major mood disorders in multiple sclerosis (MS) patients has been reported. In this study, we investigated the frequency of previous or present major mood disorders in 65 patients with clinically definite multiple sclerosis (Poser criteria) and in 31 polyneuropathy (PNP) patients. All patients underwent a questionnaire designed after DSM-IV definitions for major mood disorders. A higher lifetime risk for development of a major mood disorder was evident in MS patients (log rank test.,p<0.001). Of all MS patients with a major mood disorder, at least 34% had one first-degree relative affected by a mood disorder, while the corresponding figure was 14% among PNP cases. Our data confirm the high lifetime risk for depression in MS patients and suggest that, at least in a subset of MS patients with depression, the genetic basis for depression operates with similar mechanisms as those at work in families with primary depression. However, this is not necessarily true for other subsets of depressed MS patients' families.

Key words

Multiple sclerosis Affective disorders 


Un'elevata prevalenza di disturbi dell'umore è stata più volte segnalata nei pazienti con sclerosi multipla (SM). Abbiamo pertanto studiato la prevalenza dei disturbi dell'umore in 65 pazienti con SM e 31 pazienti con polineuropatie (PNP). Tutti i pazienti venivano sottoposti ad intervista strutturata con un questionario basato sulle definizioni del DSM-IV relative ai disturbi dell'umore. Il rischio cumulativo di sviluppo di depressione maggiore era più elevato nella SM che nelle PNP. Il 34% dei pazienti con SM e disturbi dell' umore presentavano almeno un parente di primo grado con disturbi dell'umore, control il 14% per i pazienti con PNP e disturbi dell' umore. I nostri dati confermano l'elevato rischio cumulativo di depressione nella SM e suggeriscono che in un sottogruppo di pazienti con SM e depressione, la base genetica della depressione opera con meccanismi analoghi a quelli in atto nelle famiglie con depressione primaria.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Joffe RT, Lippert GP, Gray TA, Sawa G, Homath Z (1987) Mood disorders and multiple sclerosis. Arch Neurol 44:376–378Google Scholar
  2. 2.
    Minden SL, Orav J, Reich P (1987) Depression in multiple sclerosis. Gen Hosp Psychiatry 9:426–434Google Scholar
  3. 3.
    Schiffer RB, Caine ED, Bamford KA, Levy S (1983) Depressive episodes in patients with multiple sclerosis. Am J Psychiatry 140:1498–1950Google Scholar
  4. 4.
    Nassberger L, Traskman-Bendz Z (1983) Increased soluble interleukin-2 receptor concentrations in suicide attempters. Acta Psychiatr Scand 88:48–52Google Scholar
  5. 5.
    Cotrell SS, Wilson SAK (1926) The affective symptomatology of disseminated sclerosis. J Neurol Psychopathol 7:1–30Google Scholar
  6. 6.
    Kahana E, Leibowitz U, Alter M (1971) Cerebral multiple sclerosis. Neurology 21:1179–1185Google Scholar
  7. 7.
    Sullivan MSL, Weinshenker B, Mikail S, Bishop SR (1995) Screening for major depression in the early stages of multiple sclerosis. Can J Neurol Sci 22:228–231Google Scholar
  8. 8.
    Surridge D (1969) An investigation into some psychiatric aspects of multiple sclerosis. Br J Psychiatry 115:749–764Google Scholar
  9. 9.
    Sadovnick AD, Remick RA, Allen J, et al (1996) Depression and multiple sclerosis. Neurology 46:628–632Google Scholar
  10. 10.
    Poser CM, Paty DW, Scheinberg L, et al (1983) New diagnostic criteria in multiple sclerosis: Guidelines for research protocols. Ann Neurol 13:227–231Google Scholar
  11. 11.
    Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–63Google Scholar
  12. 12.
    Beck AT, Beck RW (1972) Screening depressed patients in family practice: A rapid technique. Postgrad Med 52:81–85Google Scholar
  13. 13.
    De Renzi E, Vignolo LA (1962) The Token test: A sensitive test to detect receptive disturbances in aphasia. Brain 85:665–678Google Scholar
  14. 14.
    Spinnler H, Tognoni G and the Gruppo Italiano per to studio neuropsicologico dell'invecchiamento (1987) Standardizzazione e taratura Italiana di test neuropsicologici. Ital J Neurol Sci [Suppl] 8:74–78Google Scholar
  15. 15.
    Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state: A pratical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198Google Scholar
  16. 16.
    Raven JC (1965) Guide to using the Coloured Progressive Matrices, London. HK Lewis, Psychological Comparation, New YorkGoogle Scholar
  17. 17.
    Wechsler D (1945) A standardized memory scale for clinical use. J Psychol 19:87–95Google Scholar
  18. 18.
    Wechsler D (1955) Wechsler adult intelligence scale manual. Psychological Comparation, New YorkGoogle Scholar
  19. 19.
    Schubert DSP, Foliart RH (1993) Increased depression in multiple sclerosis patients. A meta-analysis. Psychosomatics 34(2):124–130Google Scholar
  20. 20.
    Faravelli C, Guerrini Degl'Innocenti B, Aiazzi L, Incerpi G, Pallanti S (1990) Epidemiology of mood disorders: A community survey in Florence. J Affect Disord 20:135–141Google Scholar
  21. 22.
    Whitlock FA, Siskind MM (1980) Depression as a major symptom of multiple sclerosis. J Neurol Neurosurg Psychiatry 43:861–865Google Scholar
  22. 23.
    Moller A, Wiedemann G, Rohde U, Sonntag A (1994) Correlates of cognitive impairment and depressive mood disorder in multiple sclerosis. Acta Psychiatr Scand 89:117–121Google Scholar
  23. 24.
    Nylev Stenager E, Stenager E, Koch-Henriksen N, Bronnum-Hansen H, Hyllested K, Jensen K, Bille-Brahe U (1992) Suicide and multiple sclerosis: An epidemiological investigation. J Neurol Neurosurg Psychiatry 55:542–545Google Scholar
  24. 25.
    Nylev Stenager E, Koch-Henriksen N, Stenager E (1996) Risk factors for suicide in multiple sclerosis. Psychother Psychosom 65:86–90Google Scholar
  25. 26.
    Ebers GC (1994) Genetics and multiple sclerosis: An overview. Ann Neurol 36:12–14Google Scholar
  26. 27.
    Ebers GC, Sadovnick AD (1994) The role of genetic factors in multiple sclerosis susceptibility. J Neuroimmunol 54:1–17Google Scholar
  27. 28.
    Risk N, Botstein D (1996) A manic depressive history. Nat Genetics 12:351–353Google Scholar
  28. 29.
    Cross-national collaborative group (1992) The changing rate of major depression. Cross national comparisons. JAMA 268:3098–3105Google Scholar
  29. 30.
    Sommer N, Loschmann PA, Northoff GH, et al (1995) The antidepressive rolipram suppresses cytokine production and prevents autoimmune encephalomyelitis. Nat Med 1:244–248Google Scholar
  30. 31.
    Warren S, Warren KG, Cockerill R (1991) Emotional stress and coping in multiple sclerosis (MS) exacerbations. J Psychosom Res 35:37–47Google Scholar

Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • A. Salmaggi
    • 1
  • R. Palumbo
    • 1
  • L. Fontanillas
    • 1
  • M. Eoli
    • 1
  • L. La Mantia
    • 1
  • A. Solari
    • 1
  • D. Pareyson
    • 1
  • C. Milanese
    • 1
  1. 1.National Neurological Institute “C. Besta”MilanoItaly

Personalised recommendations