Unmet psychosocial needs of people with multiple sclerosis

BACKGROUND: Multiple sclerosis (MS) is an autoimmune illness in the immune system that attacks myelin segments in the brain and spinal cord. Symptoms are diverse and unpredictable, appearing in varying combinations and patterns. Many patients suffer from additional behavioural and psychiatric symptoms, ranging from stress-related disorders, neurotic and affective disorders to psychotic disorders and even cognitive impairment and dementia. This review aimed at identifying unmet needs accompanying MS (that can be combined with unmet needs in psychiatric disorders).METHOD: Articles published between January 1970 and December 2021 were screened by a computerized search of the literature, using keywords multiple sclerosis, in successive combination with needs, psychosocial aspects, quality of life, psychiatric diseases, adjust-ment disorder, depression, cognitive deficit, anxiety disorder, psychopharmacs, psycho-therapy, or cognitive behavioural therapy, and family.RESULTS: There is a significant, though not a very strong association between stress and exacerbation of MS. Patients with MS have various psychosocial needs. However, fulfilling them may be challenging. Problematic areas include lifestyle and self-care, work and social environment and even sexual relationships. The individual's reaction to the MS diagnosis considerably depends on their personality traits and coping capacities. Unexpected exac-erbations may arise and interfere with the patient's desires and plans. Psychological and emotional challenges associated with MS can reflect the immediate effects of the disease, such as structural brain abnormalities and disease characteristics, and the secondary impli-cations of the complex interplay of long-standing personality dynamics with the adaptive demands of dealing with compromised functioning and uncertainty. MS associated with the psychiatric condition can pose a challenge for effective treatment. Sometimes it might be difficult to distinguish whether the symptoms are caused by MS, psychiatric disorder, unmet psychosocial needs or an adverse effect of the treatment.CONCLUSION: A neuropsychologically informed psycho-therapy could be an essential component of our patients' treatment regimens as they cope with the losses in adap-tive functioning, inefficiencies in cognitive processing , the compromising effects of stress , fatigue on neuropsychological status and quality of life.