scholarly journals PSYCHIATRIC DISORDERS IN THE COURSE OF MULTIPLE SCLEROSIS

2020 ◽  
Vol 73 (8) ◽  
pp. 1780-1784
Author(s):  
Magdalena Zając ◽  
Patryk Główczyński ◽  
Karina Agnieszka Badura Brzoza
Keyword(s):  
Multiple Sclerosis ◽  
Bipolar Disorder ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Treatment Process ◽  
Demyelinating Disease ◽  
Mental Diseases ◽  
The Central Nervous System ◽  
Disease Experience

Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system of a chronic nature, most often with periods of exacerbation and remission, mainly affecting people between 20-40 years of age, with a slight prevalence of women. The aim of the study was to collect and analyze materials published in the literature regarding the prevalence and co-occurrence of mental disorders in patients with multiple sclerosis. Current reports show that as many as 75% of patients with this chronic disease experience various mental disorders, and the incidence of mental diseases - including mood disorders and anxiety disorders - is statistically higher than in the general population. Conclusions: Depending on the literature, depressive symptoms appear in 6.94% -70.1% of patients with MS. Diagnosis of anxiety disorders affects 11.1% of patients, while bipolar disorder affects up to 16.2%. Co-occurrence of MS with schizophrenia is estimated at 1.28%. The incidence of other psychoses is 2-4% in patients with MS. Only in the case of schizophrenia, men with MS are more likely to develop it, while other psychiatric disorders are more common among women. Co-occurrence of mental disorders in the course of multiple sclerosis adversely affects the treatment process and the functioning of patients and their families.

Prevalence of psychiatric disorders among patients with Multiple Sclerosis: a cross-sectional study.

2020 ◽  
Author(s):  
Michał Błachut ◽  
Anna Rebeka Szczegielniak ◽  
Krzysztof Świerzy ◽  
Magdalena Zając- Tarska ◽  
Katarzyna Kubicka-Bączyk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Underlying Disease ◽  
Psychiatric Evaluation ◽  
Cross Sectional ◽  
Mini International Neuropsychiatric Interview ◽  
Sociodemographic Data ◽  
Number Of Patients

Abstract Background: Multiple Sclerosis is one of the leading autoimmune disorders causing disability among young adults. Various types of mood, affect, and behaviour disorders along with cognitive impairment can be manifested in a course of MS, with affective and anxiety disorders being the most prevalent. Mental health challenges, in addition to the neurological burden of MS, significantly affect quality of life and the course of the underlying disease. Objective: The aim of this work was to determine the prevalence of mental disorders in a sample of MS patients during outpatient treatment in Zabrze, Poland, with a focus on those with mood and anxiety disorders, and to compare the results obtained in these groups with clinical and sociodemographic data. Method: The study was conducted between 2017 and 2018 on 103 MS patients of the Neurological Outpatient Clinic of the Medical University of Silesia Hospital No.1 in Zabrze, Poland. During the study, sociodemographic data were collected, as well as the type and course of the underlying disease, comorbidities, and medicines used. The MINI-international neuropsychiatric interview and a psychiatric examination were utilized to assess the occurrence of mental disorders. Result: 68% of all patients received a psychiatric diagnosis at some point in their life with only 4% having been hospitalized before; 49.5% met the diagnostic criteria for various psychiatric disorders. Measured by the MINI International Neuropsychiatric Interview, 33% of patients reported a past episode of major depression while 8.7% met the criteria for a current episode. The same number of patients admitted ongoing treatment due to recurrent depressive disorder. In regards to anxiety disorders, the most common was generalized anxiety disorder (10.7%), followed by agoraphobia (8.7%), panic disorder (7.8%), and social phobia (4.9%). Most of the patients (94.2%) at the time of the psychiatric evaluation presented a low level of suicide risk, while 1.9% of the patients presented a medium risk, and 3.9% - a high risk. Conclusion(s): The study confirmed a significantly higher prevalence of mental disorders among MS patients; thus, the psychiatric state of patients in this group should be investigated systematically, simultaneously with the assessment of their neurological state. Trial registration: N/A Key words: Multiple Sclerosis, psychiatric disorders, comorbidity, psychiatric care, clinical characteristics.

Stress and Mental Disorders: Insights from Animal Models

2020 ◽  
Author(s):  
Richard McCarty
Keyword(s):  
Bipolar Disorder ◽  
Animal Models ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Inbred Mice ◽  
Autism Spectrum ◽  
Post Traumatic Stress ◽  
Behavioral Alterations ◽  
Dynamic Interactions

Stress has now been recognized as an important factor in the development or recurrence of various mental disorders, from major depressive disorder to bipolar disorder to anxiety disorders. Stressful stimuli appear to exert their effects by acting upon individuals with susceptible genotypes. Over the past 50 years, animal models have been developed to study these dynamic interactions between stressful stimuli and genetically susceptible individuals during prenatal and postnatal development and into adulthood. This book begins with a discussion of the history of psychiatric diagnosis and the recent goal of moving toward precision psychiatry, followed by a review of clinical research on connections between stressful stimuli and the development of psychiatric disorders. Chapters are also included on neuroendocrine, immune, and brain systems involved in responses to stress. Additional chapters focus on the development of animal models in psychiatry and the susceptibility of the developing organism to stressful stimuli. Subsequent chapters are devoted to animal models of specific stress-sensitive psychiatric disorders, including schizophrenia, autism spectrum disorders, bipolar disorder, anxiety disorders, depression, and post-traumatic stress disorder. These chapters also focus on the identification of promising molecular targets for development of new drug therapies; a chapter examines animal models of resilience to stress-induced behavioral alterations as a newer approach to understand why some animals (e.g., inbred mice) are susceptible to stress and others are resilient, even if they are essentially genetically identical. The final chapter discusses how these basic laboratory animal models are providing promising leads for future breakthroughs in the diagnosis, treatment, and prevention of mental disorders.

scholarly journals HIV infection and multiple sclerosis: a case with unexpected “no evidence of disease activity” status

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199957
Author(s):  
Fernando Labella ◽  
Fernando Acebrón ◽  
María del Carmen Blanco-Valero ◽  
Alba Rodrígez-Martín ◽  
Ángela Monterde Ortega ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hiv Infection ◽  
Disease Activity ◽  
Demyelinating Disease ◽  
Clinical Course ◽  
Disease Modifying Drugs ◽  
Immunodeficiency Virus ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Disease Modifying

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system whose etiology remains unclear. It has been suggested that MS can be triggered by certain viruses; however, human immunodeficiency virus (HIV) infection is associated with reduced incidence of MS. We present the case of a young patient diagnosed with active relapsing-remitting MS whose clinical course substantially improved following HIV infection and treatment. The patient achieved no evidence of disease activity status without any disease-modifying drugs. Both HIV-induced immunosuppression and antiretroviral therapy may have attenuated the clinical course in this patient.

Recent advances on immunosuppressive drugs and remyelination enhancers for the treatment of multiple sclerosis

2021 ◽  
Vol 27 ◽  
Author(s):  
Jennifer Cadenas-Fernández ◽  
Pablo Ahumada-Pascual ◽  
Luis Sanz Andreu ◽  
Ana Velasco
Keyword(s):  
Multiple Sclerosis ◽  
Intracellular Signaling ◽  
Demyelinating Disease ◽  
Lipid Synthesis ◽  
Immunosuppressive Drugs ◽  
Nerve Fibers ◽  
Myelin Sheaths ◽  
Demyelinating Lesions ◽  
The Central Nervous System ◽  
Lipid Structures

: Mammalian nervous systems depend crucially on myelin sheaths covering the axons. In the central nervous system, myelin sheaths consist of lipid structures which are generated from the membrane of oligodendrocytes (OL). These sheaths allow fast nerve transmission, protect axons and provide them metabolic support. In response to specific traumas or pathologies, these lipid structures can be destabilized and generate demyelinating lesions. Multiple sclerosis (MS) is an example of a demyelinating disease in which the myelin sheaths surrounding the nerve fibers of the brain and spinal cord are damaged. MS is the leading cause of neurological disability in young adults in many countries, and its incidence has been increasing in recent decades. Related to its etiology, it is known that MS is an autoimmune and inflammatory CNS disease. However, there are no effective treatments for this disease and the immunomodulatory therapies that currently exist have proven limited success since they only delay the progress of the disease. Nowadays, one of the main goals in the MS research is to find treatments which allows the recovery of neurological disabilities due to demyelination. To this end, different approaches, such as modulating intracellular signaling or regulating the lipid metabolism of OLs, are being considered. Here, in addition to immunosuppressive or immunomodulatory drugs that reduce the immune response against myelin sheaths, we review a diverse group of drugs that promotes endogenous remyelination in MS patients and whose use may be interesting as potential therapeutic agents in MS disease. To this end, we compile specific treatments against MS that are currently in the market with remyelination strategies which have entered into human clinical trials for future reparative MS therapies. The method used in this study is a systematic literature review on PubMed, Web of Science and Science Direct databases up to May 31, 2020. To narrow down the search results in databases, more specific keywords, such as, “myelin sheath”, “remyelination”, “demyelination”, “oligodendrocyte” and “lipid synthesis” were used to focus the search. We favoured papers published after January, 2015, but did not exclude earlier seminal papers.

scholarly journals Psychiatric disorders in multiple sclerosis patients

2009 ◽  
Vol 67 (3a) ◽  
pp. 664-667 ◽  
Author(s):  
Mirella Martins Fazzito ◽  
Sérgio Semeraro Jordy ◽  
Charles Peter Tilbery
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Disorder ◽  
Optic Neuritis ◽  
Psychiatric Disorders ◽  
Clinical Presentation ◽  
Demyelinating Disease ◽  
Common Symptom ◽  
Multiple Sclerosis Patients ◽  
Variable Clinical Presentation

Multiple sclerosis (MS) is a demyelinating disease showing variable clinical presentation. Optic neuritis is the most common symptom, followed by motor and sensitive manifestations. It is known that this disease may be related to several psychiatric disorders, especially depression. In this study we will discribe 5 cases of MS patients harboring psychiatric disorder related or unchained by the disease itself.

scholarly journals Relapsing Tumefactive Demyelination: A Case Report

2018 ◽  
Vol 47 (2) ◽  
pp. 193
Author(s):  
Ibrahim Omerhodžić ◽  
Almir Džurlić ◽  
Dino Lisica ◽  
Nevena Mahmutbegović ◽  
Maida Nikšić ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Female Patient ◽  
Demyelinating Disease ◽  
Diagnostic Procedures ◽  
Young Female ◽  
Diagnostic Challenge ◽  
Fresh Frozen ◽  
The Central Nervous System ◽  
Tumorlike Lesion

<p><strong>Objective. </strong>We present a case of relapsing tumefactive demyelination in a young female patient, that posed a real diagnostic challenge, with a heterogeneous clinical picture, atypical for multiple sclerosis (MS) presentation, and neuroradiological manifestations with a high suspicion of neoplastic diseases.</p><p><strong>Case Report</strong>. An 18-year old female patient presented to our Neurosurgical Out-patients’ Clinic with symptoms atypical for multiple sclerosis, unremarkable neurological deficit, one tumefactive lesion on MRI, followed by relapse and another two lesions within a period of six months. We decided to perform biopsy of the tumefactive lesion with compressive effect. Serological and clinical data were negative for MS, and the patient did not respond well to corticosteroid therapy. Fresh frozen tumor tissue aroused a strong suspicion of gemistocytic astrocytoma, so total resection was done, but the definitive pathohistological examination confirmed tumefactive demyelination.</p><p><strong>Conclusion</strong>. For clinicians, it is important to consider demyelinating disease in the differential diagnosis of a tumorlike lesion of the central nervous system, in order to avoid invasive and potentially harmful diagnostic procedures, especially in younger patients.</p>

scholarly journals Multiple sclerosis and psychiatric disorders: Comorbidity and sibling risk in a nationwide Swedish cohort

2014 ◽  
Vol 20 (14) ◽  
pp. 1881-1891 ◽  
Author(s):  
Viktoria Johansson ◽  
Cecilia Lundholm ◽  
Jan Hillert ◽  
Thomas Masterman ◽  
Paul Lichtenstein ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Familial Risk ◽  
Positive Association ◽  
Protective Mechanisms ◽  
Genetic Liability ◽  
Sibling Comparison ◽  
National Patient

Background: Psychiatric disorders are known to be prevalent in multiple sclerosis (MS). Objective: The objective of this paper is to study comorbidity between MS and bipolar disorder, schizophrenia and depression in a nationwide cohort and to determine whether shared genetic liability underlies the putative association. Methods: We identified ICD-diagnosed patients with MS ( n = 16,467), bipolar disorder ( n = 30,761), schizophrenia ( n = 22,781) and depression ( n = 172,479) in the Swedish National Patient Register and identified their siblings in the Multi-Generation Register. The risk of MS was compared in psychiatric patients and in matched unexposed individuals. Shared familial risk between MS and psychiatric disorders was estimated by sibling comparison. Results: The risk of MS was increased in patients with bipolar disorder (hazard ratio (HR) 1.8, 95% confidence interval (CI) 1.6–2.2, p < 0.0001) and depression (HR 1.9, 95% CI 1.7–2.0, p < 0.0001). MS risk in schizophrenia was decreased (HR 0.6, 95% CI 0.4–0.9, p = 0.005). The association between having a sibling with a psychiatric disorder and developing MS was not significant. Conclusion: We found a strong positive association between MS and bipolar disorder and depression that could not be explained by genetic liability. The unexpected negative association between MS and schizophrenia might be spurious or indicate possible protective mechanisms that warrant further exploration.

Сellular and Molecular Mechanisms of Proinflammatory Monocytes Participation in the Pathogenesis of Mental Disorders. Part 3

Psychiatry ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 125-134
Author(s):  
E. F. Vasilyeva ◽  
O. S. Brusov
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Mental Disorders ◽  
Molecular Mechanisms ◽  
Microglial Cells ◽  
Inflammatory Reactions ◽  
Mental Diseases ◽  
The Central Nervous System ◽  
The Brain

Background: at present, the important role of the monocyte-macrophage link of immunity in the pathogenesis of mental diseases has been determined. In the first and second parts of our review, the cellular and molecular mechanisms of activation of monocytes/macrophages, which secreting proinflammatory CD16 receptors, cytokines, chemokines and receptors to them, in the development of systemic immune inflammation in the pathogenesis of somatic diseases and mental disorders, including schizophrenia, bipolar affective disorder (BAD) and depression were analyzed. The association of high levels of proinflammatory activity of monocytes/macrophages in patients with mental disorders with somatic comorbidity, including immune system diseases, is shown. It is known that proinflammatory monocytes of peripheral blood, as a result of violation of the integrity of the hematoencephalic barrier can migrate to the central nervous system and activate the resident brain cells — microglia, causing its activation. Activation of microglia can lead to the development of neuroinammation and neurodegenerative processes in the brain and, as a result, to cognitive disorders. The aim of review: to analyze the results of the main scientific studies concerning the role of cellular and molecular mechanisms of peripheral blood monocytes interaction with microglial cells and platelets in the development of neuroinflammation in the pathogenesis of mental disorders, including Alzheimer’s disease (AD). Material and methods: keywords “mental disorders, AD, proinflammatory monocytes, microglia, neuroinflammation, cytokines, chemokines, cell adhesion molecules, platelets, microvesicles” were used to search for articles of domestic and foreign authors published over the past 30 years in the databases PubMed, eLibrary, Science Direct and EMBASE. Conclusion: this review analyzes the results of studies which show that monocytes/macrophages and microglia have similar gene expression profiles in schizophrenia, BAD, depression, and AD and also perform similar functions: phagocytosis and inflammatory responses. Monocytes recruited to the central nervous system stimulate the increased production of proinflammatory cytokines IL-1, IL-6, tumor necrosis factor alpha (TNF-α), chemokines, for example, MCP-1 (Monocyte chemotactic protein-1) by microglial cells. This promotes the recruitment of microglial cells to the sites of neuronal damage, and also enhances the formation of the brain protein beta-amyloid (Aβ). The results of modern studies are presented, indicating that platelets are involved in systemic inflammatory reactions, where they interact with monocytes to form monocyte-platelet aggregates (MTA), which induce the activation of monocytes with a pro inflammatory phenotype. In the last decade, it has been established that activated platelets and other cells of the immune system, including monocytes, detached microvesicles (MV) from the membrane. It has been shown that MV are involved as messengers in the transport of biologically active lipids, cytokines, complement, and other molecules that can cause exacerbation of systemic inflammatory reactions. The presented review allows us to expand our knowledge about the cellular and molecular aspects of the interaction of monocytes/macrophages with microglial cells and platelets in the development of neuroinflammation and cognitive decline in the pathogenesis of mental diseases and in AD, and also helps in the search for specific biomarkers of the clinical severity of mental disorder in patients and the prospects for their response to treatment.

Multiple Sclerosis

2018 ◽  
pp. 209-216
Author(s):  
Samuel W. Samuel ◽  
Jianguo Cheng
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Neuropathic Pain ◽  
Demyelinating Disease ◽  
Spontaneous Pain ◽  
Disease Course ◽  
The Central Nervous System ◽  
Disease Modifying ◽  
Multiple Treatments ◽  
Surgical Treatments

Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS). The diagnosis is based on evidence of at lease two different lesions in the CNS, at least two different episodes in the disease course, and chronic inflammation of the CNS as determined by analysis of the cerebrospinal fluid. Central neuropathic pain is the most common form of pain in patients with MS, with an estimated prevalence of about 50%. Along with the classical neuropathic pain features, such as spontaneous pain (dysesthesia and burning) and evoked pain (allodynia and hyperalgesia), patients with MS may also suffer from intermittent neuropathic pain, such as trigeminal neuralgia, Lhermitte sign, and glossopharyngeal neuralgia. In addition to disease-modifying therapies of MS, multiple treatments are available to manage neuropathic pain secondary to MS, including medical, interventional, and surgical treatments with varying levels of evidence.

Hormonal Contraception and the Brain: Examining Cognition and Psychiatric Disorders

2019 ◽  
Vol 15 (2) ◽  
pp. 116-131
Author(s):  
Stephanie Laird ◽  
Luke J. Ney ◽  
Kim L. Felmingham ◽  
Andrea Gogos
Keyword(s):  
Bipolar Disorder ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Oral Contraceptive Pill ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Brain

Background: The combined oral contraceptive pill (OC), containing synthetic estrogens and progestins, is used by millions of women worldwide, yet little is known about its effects on cognition or on psychiatric disorders. The progestin component of OCs determines their androgenicity, i.e. whether the OC has androgen binding components with masculinising effects or antiandrogenic components with feminising effects. Objective: The present review discusses the literature surrounding OC use and cognition in healthy women. Given the important role that sex hormones play in psychiatric disorders, we also consider the influence of OCs on symptoms of schizophrenia, post-traumatic stress disorder, depression, bipolar disorder, anxiety disorders and indirectly, sleep quality. Results: Research has shown that while there are no differences between OC users and non-users, androgenic OCs enhance visuospatial ability and anti-androgenic OCs enhance verbal fluency. Little is known about OCs effects on other cognitive domains, such as memory and executive function. There is little research examining OC use in schizophrenia, post-traumatic stress disorder, bipolar disorder and anxiety disorders. There is some evidence that OC use is associated with depression, however the exact causality of this association remains to be verified. Conclusion: We maintain that future studies need to address several methodological limitations, such as separating OCs based on androgenicity to avoid the masking effects that occur when various OCs are considered as one group. As this review highlights several significant effects of OC use on the brain, the implications of OC use needs to be considered in future research.

Sign in / Sign up

Export Citation Format

Share Document