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Psychiatric Comorbidity

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

Abstract

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system. Psychiatric comorbidities, in particular depression and anxiety, are frequent in MS patients.

These disorders are underdiagnosed and undertreated although they have been associated with decreased adherence to treatment, functional status, and quality of life. Behavioral disorders are more common than severe psychiatric disorders and are probably secondary to cognitive impairment. Addictions may be underestimated. Although the high frequency of psychiatric co-morbidity might be due to psychosocial factors, the role of demyelinization and inflammation is possible. Psychiatric comorbidities in MS deserve clinical attention because they are associated with an increase risk of suicide.

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References

  1. Patten SB, Beck CA, Williams JVA, Barbui C, Metz LM. Major depression in multiple sclerosis. A population based perspective. Neurology. 2003;61:1524–7.

    Article  CAS  PubMed  Google Scholar 

  2. Patten SB, Metz LM, Reimer MA. Biopsychosocial correlates of lifetime major depression in a multiple sclerosis population. Mult Scler. 2000;6:115–20.

    Article  CAS  PubMed  Google Scholar 

  3. Kessler RC, Berglund P, Demler O, et al. The Epidemiology of Major Depressive Disorder Results from the National Comorbidity Survey Replication. JAMA. 2003;289:3095–105.

    Article  PubMed  Google Scholar 

  4. Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler. 2007;13:67–72.

    Article  CAS  PubMed  Google Scholar 

  5. Galeazzi GM, Ferrari S, Giaroli G, et al. Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy. Neurol Sci. 2005;26:255–62.

    Article  CAS  PubMed  Google Scholar 

  6. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.

    Article  CAS  PubMed  Google Scholar 

  7. Kessler RC, Keller MB, Wittchen HU. The epidemiology of generalized anxiety disorder. Psychiatry Clin North Am. 2001;1:19–39.

    Article  Google Scholar 

  8. Edwards LJ, Constantinescu CS. A prospective study of conditions associated with multiple sclerosis in a cohort of 658 consecutive outpatients attending a multiple sclerosis clinic. Mult Scler. 2004;10:575–81.

    Article  CAS  PubMed  Google Scholar 

  9. Benazzi F. Bipolar disorder—focus on bipolar II disorder and mixed Depression. Lancet. 2007;369:935–45.

    Article  PubMed  Google Scholar 

  10. Marrie RA, Fisk JD, Yu BN, Leung S, Elliott L, Caetano P. Mental comorbidity and multiple sclerosis : validating administrative data to support population-based surveillance. BMC Neurol. 2013;13:16.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Pioro EP, Brooks BR, Cummings J, Schiffer R, Thisted RA, Wynn D, et al. Dextromethorphan Plus Ultra Low-Dose Quinidine Reduces Pseudobulbar Affect. Ann Neurol. 2010;68:693–702.

    Article  CAS  PubMed  Google Scholar 

  12. Espinola-Nadurille M, Colin-Piana R, Ramirez-Bermudez J, Lopez-Gomez M, Flores J, Arrambide G, Corona T. Mental Disorders in Mexican Patients With Multiple Sclerosis. J Neuropsychiatry Clin Neurosci. 2010;22:63–9.

    Article  PubMed  Google Scholar 

  13. Johnson SK, DeLuca J, Natelson BH. Personality dimensions in the chronic fatigue syndrome: a comparison with multiple sclerosis and depression. J Psychiatr Res. 1996;30(1):9–20.

    Article  CAS  PubMed  Google Scholar 

  14. Quesnel S, Feinstein A. Multiple sclerosis and alcohol: a study of problem drinking. Mult Scler. 2004;10(2):197–201.

    Article  PubMed  Google Scholar 

  15. Schuckit MA. Alcohol-used disorders. Lancet. 2009;373:492–501.

    Article  PubMed  Google Scholar 

  16. Fishman I, Benedict RHB, Bakshi R, Priore R, Weinstock-Guttman B. Construct validity and frequency of euphoria sclerotic in multiple sclerosis. J Neuropsychiatry Clin Neurosci. 2004;16:350–6.

    Article  PubMed  Google Scholar 

  17. Feinstein A, O’Connor P, Gray T, Feinstein KJ. The prevalence and neurobehavioral correlates of pathological laughing and crying in multiple sclerosis. Arch Neurol. 1997;54:1116–21.

    Article  CAS  PubMed  Google Scholar 

  18. Bombardier CH, Blake KD, Ehde DH, Gibbons LE, Moore D, Kraft GH. Alcohol and drug abuse among persons with multiple sclerosis. Mult Scler. 2004;10:35.

    Article  CAS  PubMed  Google Scholar 

  19. Chwastiak L, Ehde DM, Gibbons LE, Sullivan M, Bowen JD, Kraft GH. Depressive symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample. Am J Psychiatry. 2002;159:1862–8.

    Article  PubMed  Google Scholar 

  20. Rosti-Otajärvi E, Hämäläinen P. Behavioural symptoms and impairments in multiple sclerosis: a systematic review and meta-analysis. Mult Scler. 2013;19:31.

    Article  PubMed  Google Scholar 

  21. Fromont A, Binquet C, Rollot F, Despalins R, Weill A, Clerc L, Bonithon-Kopp C, Moreau T. Comorbidities at multiple sclerosis diagnosis. J Neurol. 2013;260(10):2629–37.

    Article  PubMed  Google Scholar 

  22. Tarrants, M Oleen-Burkey M., Castelli-Haley J, Lage MJ. The impact of comorbid depression on adherence to therapy for multiple sclerosis. Mult Scler Int. 2011;2011:271321.

    Google Scholar 

  23. Amato MP, Ponziani G, Rossi F, Liedl CL, Stefanile C, Rossi L. Quality of life in multiple sclerosis: the impact of depression, fatigue and disability. Mult Scler. 2001;7(5):340–4.

    Article  CAS  PubMed  Google Scholar 

  24. Fredrikson S, Cheng Q, Jiang GX, Wasserman D. Elevated suicide risk among patients with multiple sclerosis in Sweden. Neuroepidemiology. 2003;22(2):146–52.

    Article  CAS  PubMed  Google Scholar 

  25. Bronnum-Hansen H. Suicide among Danes with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2005;76(10):1457–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Sadovnick AD, Eisen K, Ebers GC, Paty DW. Cause of death in patients attending multiple sclerosis clinics. Neurology. 1991;41:1193–6.

    Article  CAS  PubMed  Google Scholar 

  27. Leray E, Morrissey S, Yaouanq J, Coustans M, Le Page E, Chaperon J, Edan G. Long-term survival of patients with multiple sclerosis in West France. Mult Scler. 2007;13(7):865–74.

    Article  CAS  PubMed  Google Scholar 

  28. Grytten Torkildsen N, Lie SA, Aarseth JH, Nyland H, Myhr KM. Survival and cause of death in Multiple sclerosis : results from a 50 year follow-up in Western Norway. Mult Scler. 2008;14:1191–8.

    Article  CAS  PubMed  Google Scholar 

  29. Feinstein A. An examination of suicidal intent in patients with multiple sclerosis. Neurology. 2002;59:674–8.

    Article  PubMed  Google Scholar 

  30. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed., text rev (DSM-IV-TR). American Psychiatric Association 2000.

    Google Scholar 

  31. Jones KH, Ford DV, Jones PA, John A, Middleton RM, Lockhart-Jones H, et al. A large-scale study of anxiety and depression in people with Multiple Sclerosis: a survey via the web portal of the UK MS Register. PLoS One. 2012;7(7), e41910.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Crawford JR, Henry JD, Crombie C, Taylor EP. Normative data for the HADS from a large non-clinical sample. Br J Clin Psychol. 2001;40:429–34.

    Article  CAS  PubMed  Google Scholar 

  33. Schiffer RB, Wineman NM. Antidepressant pharmacotherapy of depression associated with multiple sclerosis. Am J Psychiatry. 1990;147:1493–7.

    Article  CAS  PubMed  Google Scholar 

  34. Frye M. Bipolar disorder –a focus on depression. N Engl J Med. 2011;364:51–9.

    Article  CAS  PubMed  Google Scholar 

  35. Marrie RS, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T. The burden of medical comorbidity in multiple sclerosis: frequent, underdiagnosed and undertreated. Mult Scler. 2009;15:385–92.

    Article  CAS  PubMed  Google Scholar 

  36. Fisk JD, Morehouse SA, Brown MG, Skedgel C, Murray TJ. Hospital-based psychiatric service utilization and morbidity in multiple sclerosis. Can J Neurol Sci. 1998;25(3):230–5.

    CAS  PubMed  Google Scholar 

  37. Carta MG, Moro MF, Lorefice L, Trincas G, Cocco E, Del Giudice E, Fenu G, Colom F, Marrosu MG. The risk of Bipolar Disorders in Multiple Sclerosis. J Affect Disord. 2014;155:255–60.

    Article  CAS  PubMed  Google Scholar 

  38. Lacovides A, Androulakis E. Bipolar disorders and resembling special psychopathological manifestations in Multiple Sclerosis: a review. Curr Opin Psychiatry. 2011;24:336–340.

    Google Scholar 

  39. Zephir H, De Seze J, Stojkovic T, Delisse B, Ferriby D, Cabaret M, Vermersch P. Multiple sclerosis and depression: influence of interferon beta therapy. Mult Scler. 2003;9(3):284.

    Article  CAS  PubMed  Google Scholar 

  40. Diaz-Olavarrieta C, Cummings JL, Velazquez J. Garcia de la Cadena C. Neuropsychiatric manifestations of multiple sclerosis. J Neuropsychiatry Clin Neurosci. 1999;11:51–7.

    Article  CAS  PubMed  Google Scholar 

  41. Sanfilipo MP, Benedict RH, Weinstock-Guttman B, Bakshi R. Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology. 2006;66:685–92.

    Article  PubMed  Google Scholar 

  42. Parvizi J, Archiniegas DB, Bernardini GL, Hoffmann MW, Mohr JP, Rapoport MJ, et al. Diagnosis and management of pathological laughter and crying. Mayo Clin Proc. 2006;81:1482–6.

    Article  PubMed  Google Scholar 

  43. Ghaffar O, Chamelian L, Feinstein A. Neuroanatomy of pseudobulbar affect: a quantitative MRI study in multiple sclerosis. J Neurol. 2008;255:406–12.

    Article  PubMed  Google Scholar 

  44. Seliger GM, Hornstein A. Serotonin, fluoxetine, and pseudobulbar affect. Neurology. 1989;39(10):1400.

    Article  CAS  PubMed  Google Scholar 

  45. Udaka F, Yamao S, Nagata H, et al. Pathologic laughing and crying treated with levodopa. Arch Neurol. 1984;41:1095–6.

    Article  CAS  PubMed  Google Scholar 

  46. Panitch HS, Thisted RA, Smith RA, et al. Randomized controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. Ann Neurol. 2006;59(5):780–7.

    Article  CAS  PubMed  Google Scholar 

  47. Van Os J, Kapur S. Schizophrenia. Lancet. 2009;374:635–45.

    Article  PubMed  Google Scholar 

  48. Blanc F, Berna F, Fleury M, Lita L, Ruppert E, Ferriby D, et al. Inaugural psychotics events in Multiple Sclerosis. Rev Neurol. 2010;166:39–48.

    Article  CAS  PubMed  Google Scholar 

  49. Patten SB, Svenson LW, Metz LM. Psychotic disorders in MS : population-based evidence of an association. Neurology. 2005;65:1123–5.

    Article  PubMed  Google Scholar 

  50. Benedikt RHB, Priore RL, Miller CMunschauer F, Jacobs L. Personality disorders in Multiple sclerosis correlates with cognitive impairment. J Neuropsychiatry Clin Neurosci. 2001;13:70–6.

    Article  Google Scholar 

  51. De Assis Aquino Gondim F, Thomas F. Episodic hyperlibidinism in multiple sclerosis. Mult Scler. 2001;7:67.

    Article  Google Scholar 

  52. Allanson J, Bass C, Wade DT. Characteristics of patients with persistent severe disability and medically unexplained neurological symptoms: a pilot study. J Neurol Neurosurg Psychiatry. 2002;73:307–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  53. Caplan LR, Nadelson T. Multiple sclerosis and hysteria. Lessons learned from their association. JAMA. 1980;243(23):2418–21.

    Article  CAS  PubMed  Google Scholar 

  54. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–86.

    Article  PubMed  Google Scholar 

  55. Syed YY, McKeage K, Scott LJ. Delta-9-tetrahydrocannabinol/cannabidiol (sativex(®)): a review of its use in patients with moderate to severe spasticity due to multiple sclerosis. Drugs. 2014;74(5):563–78.

    Article  CAS  PubMed  Google Scholar 

  56. Clark AJ, Ware MA, Yazer E, et al. Patterns of cannabis use among patients with multiple sclerosis. Neurology. 2004;62:2098–100.

    Article  CAS  PubMed  Google Scholar 

  57. Chong MS, Wolff K, Wise K, Tanton C, Winstock A, Silber E. Cannabis use in patients with multiple sclerosis. Mult Scler. 2006;12(5):646–51.

    Article  CAS  PubMed  Google Scholar 

  58. Honarmand K, Tierney MC, O’Connor P, Feinstein A. Effects of cannabis on cognitive function in patients with multiple sclerosis. Neurology. 2011;76(13):1153–60.

    Article  PubMed Central  PubMed  Google Scholar 

  59. Ghaffar O, Feinstein A. Multiple sclerosis and cannabis: a cognitive and psychiatric study. Neurology. 2008;71:164–9.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Olivier Heinzlef MD .

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Heinzlef, O. (2015). Psychiatric Comorbidity. 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_6

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  • DOI: https://doi.org/10.1007/978-3-319-18464-7_6

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18463-0

  • Online ISBN: 978-3-319-18464-7

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