Mood disorders in multiple sclerosis: diagnosis and treatment

Author(s): Minden SL

Abstract

Emotional disturbances are common in MS and consist of disturbances of mood and disturbances of affect. The important mood disorders are major depressive disorder, dysthymic disorder, bipolar disorder, panic disorder, and generalized anxiety disorder. Their relationship to MS is multi-factorial and complex, and the extent to which they are direct consequences of the disease process or psychological reactions to it remains unclear. Whatever their cause, however, the symptoms of mood disorders in people with MS are no different from the symptoms of mood disorders in people without MS, and respond just as well to standard treatments. The disorders of affect are euphoria, pathological laughing and weeping, and other frontal lobe syndromes. These disorders result from demyelination, are some of the most characteristic symptoms of MS, and have the same implications for treatment as do other aspects of the disease. Mood and affective disturbances can cause enormous pain and suffering and lead to significant disruption of family, work, and social life. Physicians who can identify, diagnose, treat, and manage mood and affective disturbances effectively and who can help their patients and family members acknowledge these difficulties, talk about them, and accept psychiatric consultation and treatment can have a dramatic impact on the quality of their lives. This paper outlines the symptoms and diagnostic criteria for mood disorders and affective disturbances, reviews current treatment options, summarizes data from epidemiologic and pathophysiological studies, and suggests areas for future research.

Similar Articles

An exploration of anger phenomenology in multiple sclerosis

Author(s): Nocentini U, Tedeschi G, Migliaccio R, Dinacci D, Lavorgna L, et al.

Depression associated with multiple sclerosis

Author(s): Feinstein A, Feinstein K

Triggering of acute myocardial infarction onset by episodes of anger

Author(s): Mittleman MA, Maclure M, Sherwood JB, Mulry RP, Tofler GH, et al.

Styles of emotion regulation and their associations with perceived health in patients with rheumatoid arthritis

Author(s): van Middendorp H, Geenen R, Sorbi MJ, Hox JJ, Vingerhoets AJ, et al.

Emotion regulation abilities and the quality of social interaction

Author(s): Lopes PN, Salovey P, Coté S, Beers M

The role of angry rumination and distraction in blood pressure recovery from emotional arousal

Author(s): Gerin W, Davidson KW, Christenfeld NJ, Goyal T, Schwartz JE

Effects of anger and anger regulation styles on pain in daily life of women with fibromyalgia: a diary study

Author(s): van Middendorp H, Lumley MA, Moerbeek M, Jacobs JW, Bijlsma JW, et al.

Perceived behavioral changes in early multiple sclerosis

Author(s): Lima FS, Simioni S, Bruggimann L, Ruffieux C, Dudler J, et al.

Multiple sclerosis and depression

Author(s): Feinstein A

Depression in multiple sclerosis: a review

Author(s): Siegert RJ, Abernethy DA

Depression in multiple sclerosis

Author(s): Minden SL, Orav J, Reich P

The role of anger in generalized anxiety disorder

Author(s): Deschênes SS, Dugas MJ, Fracalanza K, Koerner N

Age, anger regulation and well-being

Author(s): Phillips LH, Henry JD, Hosie JA, Milne AB

Specific impairments of emotion perception in multiple sclerosis

Author(s): Phillips LH, Henry JD, Scott C, Summers F, Whyte M, et al.

Attentional lapses, emotional regulation and quality of life in multiple sclerosis

Author(s): Phillips LH, Saldias A, McCarrey A, Henry JD, Scott C, et al.