Psychiatric comorbidity, particularly depression and anxiety, is common in multiple sclerosis. A systematic review of 118 studies found the prevalence of psychiatric disorders as follows:
• depression, 23%
• anxiety, 22%
• alcohol abuse, 15%
• bipolar disorder, 6%
• psychosis, 4%
• substance abuse, 3%
The study authors note that developing a consistent approach to measuring psychiatric comorbidity would enhance future studies.
Citation: Marrie RA, Reingold S, Cohen J, et al. The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic review. Mult Scler. 2015;21(3):305-317.
Commentary: Multiple sclerosis disease impact is classically gauged by physical disability characterized by neurological examination findings from EDSS. White matter disconnection impacts more than just walking, coordination, and vision, however. This very important review clearly demonstrates the high incidence of psychiatric disorders — specifically anxiety and depression — in patients with MS, not only at presentation but the increasing incidence over time. Mood can impact reported fatigue, employment, quality of life, and adherence to medications. The MS clinician no longer can entirely focus on relapse and MRI, but must evaluate and address mood-related problems in MS care to provide quality care and effective intervention of not only symptoms but long-term disease management as well. –Mark Gudesblatt, MD, Medical Director of the Comprehensive MS Care Center at South Shore Neurologic Associates in Islip, NY