Assessing and treating psychiatric disorders in patients with multiple sclerosis (MS) may improve their quality of life and disease prognosis, according to researchers at Harvard Medical School, who presented their work titled “Neuropsychiatric Disorders in Multiple Sclerosis: Assessment and Management” at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting June 1-4 in National Harbor, Maryland.
Psychiatric disorders such as depression and anxiety are common in MS patients, and are often associated with decreased adherence to treatment and poorer quality of life. These disorders, however, are often under-recognized and under-treated, revealing the need for effective assessment and treatment to improve patients’ well-being, quality of life, adherence to treatment, and prognosis.
The researchers, led by Laura T. Safar, based on literature on neuropsychiatric disorders in MS, summarized the clinical presentations of the most prevalent psychiatric disorders in these patients. Then the team designed and implemented a systematic and evidence-based approach that allowed them to assess and treat MS patients at their clinic.
Researchers presented data on a variety of neuropsychiatric disorders, focusing particularly on mood and anxiety disorders, cognitive disabilities, and affect disturbances such as pathological crying or laughing. A detailed analysis of each disorder was shown regarding their prevalence, mechanisms, clinical presentation, assessment, and treatment.
The authors claimed that the clinical presentation of these psychiatric events in MS patients is often different from those found in patients with primary psychiatric disorders, as patients commonly present other MS symptoms, such as fatigue, sleep disturbances, and pain. In addition, brain lesions, or the administration of a variety of drugs in MS patients, may also affect their emotional manifestations.
The presented model was shown to be a systematic and efficient clinical approach for the assessment of psychiatric disorders in patients with MS, as it screens both the most prevalent psychiatric and non-psychiatric conditions through validated scales.
A variety of treatments have been employed in these patients, including disease-modifying drugs, psychopharmacology, fatigue and pain treatment, and physical therapy, among others. The authors believe that the proper assessment and treatment of psychiatric disorders in MS patients may increase their quality of life and adherence to treatment, and, as a result, improve their prognosis.
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