Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-30T10:30:46.776Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric morbidity in multiple sclerosis: a clinical and MRI study

Published online by Cambridge University Press:  09 July 2009

M. A. Ron  and
S. J. Logsdail
M. A. Ron*
Affiliation:
National Hospital for Nervous Diseases, London
S. J. Logsdail
Affiliation:
National Hospital for Nervous Diseases, London
*
1Address for correspondence: Dr M. A. Ron, The National Hospital for Nervous Diseases, Queen Square, London WC1N 3BG.
Get access Rights & Permissions [Opens in a new window]

Synopsis

This study reports the psychiatric morbidity in 116 patients with definite multiple sclerosis (MS). The presence of brain pathology was investigated using magnetic resonance imaging (MRI). A group of 48 physically disabled controls suffering from rheumatic or neurological conditions not involving the brain was used for comparison. Normative MRI data were obtained from a group of 40 healthy volunteers.

Psychiatric morbidity was significantly higher in the MS group with nearly half of the patients scoring as cases at interview. There was no evidence to suggest that psychiatric symptoms in isolation were the first manifestation of MS in the present material. The presence of psychiatric illness at interview was significantly related to the degree of social stress as perceived by the patient. The severity of MRI abnormalities was greater in those with longer histories and greater physical disability, but did not show a significant relationship with global measures of psychiatric disability. Of the various psychiatric symptoms elation was significantly correlated with the presence of widespread MRI abnormalities, while flattening of affect, delusions and thought disorder correlated with the degree of pathology in the temporo-parietal region.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 4 , November 1989 , pp. 887 - 895
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beck, A. T, Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571CrossRefGoogle ScholarPubMed
Braceland, F. J. & Giffin, M. E. (1950). The mental changes associated with multiple sclerosis. In Multiple Sclerosis and Demylinating Diseases (ed. Woltman, H W, Merritt, H. H., Wortis, S. B. and Hare, C. C.), pp. 450–455. Williams and Wilkins: Baltimore.Google Scholar
Bridges, K W. & Goldberg, D. P. (1984). Psychiatric illness in patients with neurological disorders: patients' views on discussion of emotional problems with neurologists British Medical Journal 289, 656–656.CrossRefGoogle ScholarPubMed
Charcot, J M. (1877). Lectures on the Diseases of the Nervous System New Sydenham Society: London.Google Scholar
Cottrell, S. S. & Wilson, S. A. K. (1926). The affective symptomatology of disseminated sclerosis. Journal of Neurology and Psychopathology 7, 1–1.CrossRefGoogle ScholarPubMed
Davison, K. & Bagley, C. R. (1969). Schizophrenia-like psychoses associated with organic disorder of the central nervous system: a review of the literature. In Current Problems in Neuropsychiatry (ed. Herrington, R N.), pp. 113–184. Headley: Ashford KentGoogle Scholar
Fazekas, F., Offenbacher, H, Fuchs, S., Schmidt, R., Niederkorn, K., Horner, S. & Lechner, H. (1988). Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis Neurology 38, 1822–1822.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Mini Mental State’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–189.CrossRefGoogle Scholar
Gerard, G. & Wisberg, L. A. (1986). MRI periventricular lesions in adults. Neurology 36, 998–998.CrossRefGoogle ScholarPubMed
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. Oxford University Press London.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970). Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal 2, 439–439.CrossRefGoogle Scholar
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardised psychiatric interview for use in community surveys. British Journal of Preventative Social Medicine 24, 18–18.Google ScholarPubMed
Horner, W. G., Hurwitz, T., Li, D. K. B, Palmer, M. & Paty, D. W. (1987). Temporal lobe involvement in multiple sclerosis patients with psychiatric disorders. Archives of Neurology 44, 187–187.CrossRefGoogle Scholar
Jenkins, R., Mann, A. H. & Belsey, E. (1981) Design and use of a short interview to assess social stress and support in research and clinical settings. Social Science and Medicine 151, 195–195.Google Scholar
Joffe, R. T., Lippert, G. P., Gray, T. A., Sawa, G. & Horvath, Z. (1987). Mood disorder and multiple sclerosis. Archives of Neurology 44, 376–376.CrossRefGoogle ScholarPubMed
Krupp, L. B., Alvarez, L. A., LaRocca, N. G. & Scheinberg, L. C. (1988). Fatigue in multiple sclerosis. Archives of Neurology 45, 435–435.CrossRefGoogle ScholarPubMed
Logsdail, S. J., Callanan, M. M. & Ron, M. A. (1988). Psychiatric morbidity in patients with clinically isolated lesions of the type seen in multiple sclerosis: a clinical and MRI study. Psychological Medicine 18, 355–355.CrossRefGoogle ScholarPubMed
Matthews, W. B. (1979). Multiple sclerosis presenting with acute remitting psychiatric symptoms. Journal of Neurology Neurosurgery and Psychiatry 42, 859–859.CrossRefGoogle ScholarPubMed
Ormerod, I E. C., Miller, D. H., McDonald, W. I., du Boulay, E. P. G. H., Rudge, P., Kendall, B. E.Moseley, I. F., Johnson, G., Tofts, P S., Halliday, A. M., Bronstein, A. M., Scaravilli, F., Harding, A. E, Barnes, D. & Zilkha, K. J. (1987). The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions: a quantitative study. Brain 110, 1579–1579.CrossRefGoogle ScholarPubMed
Peyser, J. M., Edwards, K. R. & Poser, C. M. (1980). Psychological profiles in patients with multiple sclerosis: a preliminary investigation. Archives of Neurology 37, 437–437.CrossRefGoogle ScholarPubMed
Poser, C. M., Paty, D. W., Scheinberg, L., McDonald, W. I., Davis, S. A., Ebers, G. C I., Johnson, K. P., Sibley, W. A., Silberberg, D. H. & Tourtelotte, W. W. (1983). New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Annals of Neurology 13, 227–227.CrossRefGoogle ScholarPubMed
Pratt, R. T. C. (1951). An investigation of the psychiatric aspects of disseminated sclerosis. Journal of Neurology Neurosurgery and Psychiatry 14, 326–326.CrossRefGoogle ScholarPubMed
Rabins, P. V., Brooks, B. R, O'Donell, P., Pearlson, G. D., Moberg, P., Jubelt, B., Coyle, P., Dalos, N. & Folstein, M. F. (1986). Structural brain correlates of emotional disorder in multiple sclerosis. Brain 109, 585–585.CrossRefGoogle ScholarPubMed
Schiffer, R. B., Caine, E. D., Bamford, K. A. & Levy, S. (1983). Depressive symptoms in patients with multiple sclerosis. American Journal of Psychiatry 140, 1498–1498.Google ScholarPubMed
Schiffer, R. B. & Barbigian, H. M. (1984). Behavioural disorders in multiple sclerosis, temporal lobe epilepsy and amyotrophic lateral sclerosis. Archives of Neurology 41, 1067–1067.CrossRefGoogle ScholarPubMed
Skegg, K., Corwin, P. A. & Skegg, D. C. G. (1988). How often is multiple sclerosis mistaken for a psychiatric disorder? Psychological Medicine 18, 733–733.CrossRefGoogle ScholarPubMed
Surridge, D. (1969). An investigation into some psychiatric aspects of multiple sclerosis. British Journal of Psychiatry 115, 749–749.CrossRefGoogle ScholarPubMed
Whitlock, F. A. & Siskind, M. M. (1980). Depression as a major symptom of multiple sclerosis. Journal of Neurology Neurosurgery and Psychiatry 43, 861–861.CrossRefGoogle Scholar