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Query: UMLS:C0011570 (depression)
172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-two patients with clinically definite multiple sclerosis were evaluated with neuropsychological procedures and magnetic resonance imaging (MRI). Neuropsychological evaluation included assessment of language, memory, cognition, visuospatial skills, and depression. Significant impairment in any three areas, compatible with diagnosis of a dementia syndrome, was observed in 28% of these patients, and lesser or no cognitive impairment characterized the remaining patients. Magnetic resonance imaging was used to evaluate the number and distribution of lesions as well as the presence of cerebral atrophy and atrophy of specific anatomic structures such as the corpus callosum. Results suggest that neither the number of lesions, the distribution of lesions, nor the extent of generalized cerebral atrophy was significantly greater in demented compared with non-demented patients. The primary finding was that atrophy of the corpus callosum was significantly more extensive on MRI scans in demented patients. Although the callosum itself may not be implicated directly in the pathogenesis of dementia, the presence of callosal atrophy on MRI scans should alert the physician to the possible occurrence of dementia in patients with multiple sclerosis.
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PMID:Magnetic resonance imaging correlates of dementia in multiple sclerosis. 359 63

Reports of frequency and interpretation of intellectual and mood disorders differ in multiple sclerosis (MS). Forty-one patients with MS defined according to MacAlpine's criteria were evaluated by psychometric tests (WAIS) and neuropsychologic examinations (study of language, gnosic and praxic activities, dynamic gestural organization, memory and learning) together with, in 24 of them, the AMDP psychopathologic rating scale. Intellectual disorders were noted in 65 p. 100 of patients. Although more frequent in severe and chronic forms they were nevertheless of early onset since more than a half of the patients with onset of disease less than 5 years ago were affected. Their semiology was fairly homogeneous, combining disturbances of dynamic gestural organization (decomposition or simplification) and memory and learning deficiencies without anomalies of instrumental functions or usual psychometric mental deterioration. Application of the AMDP scale failed to reveal any psychotic type of disorders. Mood disturbances were predominant, affecting 60 p. 100 of the subpopulation studied (24 cases) and combining, in an unexpected manner: dysphoria, euphoria and depression. Only euphoria appeared to be correlated with intellectual disorders. Frequency of both intellectual and mood disorders was similar to that reported in other series published. The relative homogeneity of semiology, seen by the correlation between the different disturbances (decomposition and simplification, plateau learning curve and euphoria) and the unusual grouping of these effects, is suggestive of their organic basis. In addition, signs and symptoms resemble the neuropsychological expression of frontal lobe lesions and certain lesions of central grey nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intellectual and mood disorders in multiple sclerosis]. 367 62

Eighty-seven patients with definite multiple sclerosis (MS) were examined neurologically and administered the Mini-mental State examination (MMS) to assess cognitive disability at the beginning and end of a one-year study. A CT scan was performed in 37. A group of 16 patients with stable spinal cord injuries (SCI) were studied in a similar manner. Of the MS patients, 47% had a mean General Health Questionnaire (GHQ) score in the abnormal range. This was a higher rate than in SCI patients (P = 0.004). Mean depression scores were similar in MS and SCI patients, but MS patients with brain involvement were more depressed than those with cord lesions only (P = 0.05). Depression score was unrelated to functional disability but was correlated with the degree of neurological impairment (P = 0.03). Euphoric patients were more likely to have brain involvement (P = 0.006), to have progressive MS (P less than 0.0001), and to have enlarged ventricles (P = 0.04) and were more impaired cognitively (P = 0.04) than noneuphoric patients. These results suggest that depression in MS patients is partly determined by the presence of brain involvement, but that it is also an emotional reaction to the disorder. Euphoria and cognitive disorder are reflections of brain involvement.
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PMID:Structural brain correlates of emotional disorder in multiple sclerosis. 373 Aug 6

A systematic psychiatric evaluation was performed on 100 consecutive patients attending a multiple sclerosis clinic. Forty-two percent of the patients had lifetime history of depression, and 13% fulfilled criteria for manic-depressive illness. Only 28% of the patients had no psychiatric diagnosis. The relationship of psychiatric disorder to neurologic dysfunction and other aspects of multiple sclerosis are presented. Clinical and theoretical implications of these findings are discussed.
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PMID:Mood disorder and multiple sclerosis. 382 92

Patients with bilateral forebrain disease may commonly manifest the syndrome of pathologic laughing and weeping. We investigated the efficacy of low-dose amitriptyline in 12 patients in whom this syndrome was a consequence of multiple sclerosis. In a double-blind crossover study comparing amitriptyline with placebo, eight patients experienced dramatic and significant improvement with amitriptyline (P = 0.02). The mean dose of amitriptyline was 57.8 mg per day and did not exceed 75 mg per day in any patient. Concurrent measurements of depression showed no change during the study. We conclude that amitriptyline is effective in the treatment of this disturbance of affective expression, and that this effect is distinct from the antidepressant effect of the medication.
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PMID:Treatment of pathologic laughing and weeping with amitriptyline. 388 72

In dealing with our multiple sclerosis (MS) patients concomitant and consecutive symptoms of a psychical nature also deserve appropriate consideration in addition to the variety of somatic symptoms. In the following synopsis, numerous and in part divergent findings - observations, hospital statistics as well as psychodiagnostic test results - concerning the psychopathology of MS are presented. A multiplicity of mental changes, depending upon the variability of the disease process and its course, can be noticed. Over the past century euphoria was long regarded as the psychopathological trait of MS. Along with transitions in patient populations in the meantime hardly more euphoric than depressive moods are registered. Euphoric mood aberrations are to be regarded as substrate dependent disturbances, which deteriorate parallel to disease duration and severity. Intellectual dysfunctions as well as topical brain symptoms (so-called "instrumental disabilities"), obsessive laughing and crying also reflect the basic organic process. Concerning other symptoms such as depression or dysphoria, emotional lability or lack of drive, at its extreme apathy, one cannot definitely determine to what extent - in view of a multidimensional approach - these are to be regarded as mental correlates of the disease process, or as individual reactions to the disease along with considerable social consequences. Psychoses, rarely occurring in MS, can be classified either as organic, or, in seldom cases, as a fortuitous coincidence of MS and endogenous psychosis.
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PMID:[Psychological changes in multiple sclerosis]. 397 31

To effectively care for individuals with multiple sclerosis (MS) the practitioner must be able to understand the common psychologic sequellae. These include not only those engendered by the patient's reaction to the disease, but also those reflecting alterations in central nervous system function. Although research literature on MS has many pitfalls and the quality of the results is thus uneven, important psychologic aspects of MS that have been consistently reported are depression and anxiety, euphoria, often in association with some degree of dementia, denial of illness or of impairments, irritability and apathy, coexisting psychiatric disorders, and cognitive impairment, particularly involving sensorimotor function, primary memory, and conceptual ability.
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PMID:Multiple sclerosis: understanding the psychologic implications. 401 81

Cognitive impairments, often unrecognized in multiple sclerosis, include memory loss, new learning problems, denial and depression. Spasticity and incoordination of the oropharyngeal and respiratory muscles create functional problems with speech and swallowing. Genitourinary problems include sexual dysfunction and neurogenic bladder. Specific measures can be used to alleviate these problems.
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PMID:Multiple sclerosis: Part II. Common functional problems and rehabilitation. 406 Dec 42

This study investigates the relationship between group psychotherapy and the psychologic adjustment of patients with a primary diagnosis of multiple sclerosis (MS). It was speculated that such a program would decrease both patient depression and anxiety, at the same time increasing self-concept and self-direction. Forty-one hospitalized MS patients were screened for mental status, then administered a test battery consisting of the Depression 30, IPAT Anxiety Scale, Nowicki-Strickland Internal-External Scale, and Rosenberg Self-Esteem Scale. Following this, patients were matched into triads on the basis of pretest scores. Each member of the triad was then randomly assigned to one of three groups: insight-oriented, current events, control (nontreatment). At the end of 50 group sessions, all patients were reassessed using the same test battery. Results were analyzed by means of analysis of covariance and the nonparametric Friedman test. Post-hoc procedures were performed with the following results: 1) the insight-oriented therapy group was significantly less depressed than both the current events group and the control group and 2) both the therapy and the current events groups were significantly more internally oriented than the control. Not only does group therapy per se seem to benefit the MS patient, but any supervised group involvement appears to improve significantly patient emotional state.
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PMID:Group psychotherapy: benefits in multiple sclerosis. 407 13

To test the claim that peculiar personality bias is detectable in multiple sclerosis (MS) we used the Szondi test to investigate the psychodynamic aspects of 110 MS patients in comparison with 200 healthy subjects. MS patients appeared to have a greater need for love in a passive form than normal people, rigid defense mechanisms, difficulty in resolving their inner conflicts either by sublimation or by internalization of satisfactory new emotional experiences, feelings of autoaggressiveness, and many symptoms of depression. Some of these aspects correlate with the severity of the disease, others seem to date back to early childhood as peculiar personality patterns. An investigation of childhood events in 110 controls confirmed that MS patients had had many more unhappy experiences in childhood than might commonly be expected. Further, the oft-reported psychiatric troubles preceding MS clinical onset suggest that at least in some MS patients there are specific gaps in personality structure dating back to early phases of their development.
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PMID:Personality aspects in multiple sclerosis. 408 62


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