Psychiatric issues in multiple sclerosis

Multiple sclerosis (MS) is the most common chronic disabling disease of the central nervous system in young adults, affecting I in 1000 people in Western countries [1]. MS is a demyelinating disease of the central nervous system; a diagnosis of MS requires the occurrence of at least two neurologic events consistent with demyelination in the central nervous system that are separated temporally and anatomically. Early onset (typically between 20 and 40 years of age) and long duration of disease result in tremendous individual, family, and societal costs as well as reductions in quality of life and work productivity [2]. MS has a variable and unpredictable course, with symptoms that can include weakness, visual loss, bowel and bladder incontinence. fatigue. cognitive impairment, and mood symptoms. Persons who have MS seem to have a higher prevalence of a number of psychiatric symptoms and disorders (Table 1) [3-6]. Depression and anxiety, in particular, have been associated with decreased adherence to treatment [7], functional status [8], and quality of life [9]. This article seeks to summarize the existing literature on the epidemiology, impact, and treatment of psychiatric disorders among persons who have MS and to identify the areas in which further research is needed.