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The aim of this study was to investigate the prevalence of symptoms of depression and anxiety amongst multiple sclerosis (MS) patients, and the associations with demographic and clinical characteristics. The current treatment for depression and anxiety was also evaluated amongst the MS patients. A total of 140 MS patients from Eastern Norway underwent neuropsychiatric and clinical examinations, with registration of symptoms of depression and anxiety (Hopkins Symptom Checklist-25), as well as information about any help seeking for depression were obtained. A total of 31.4% patients reported symptoms of depression, whilst 19.3% reported anxiety; both symptoms were significantly higher than that amongst the general population (P < 0.001). Fatigue and younger age at onset were significantly associated with symptoms of depression, whilst fatigue and pain, lower Expanded Disability Status Scale score and younger age at onset were associated with symptoms of anxiety. The proportion of reported treatment of depression was 15.9% and for anxiety 11.1%. Of untreated patients with symptoms, 18.2% expressed the need for treatment. A greater focus on depression and anxiety amongst MS patients is needed to establish the appropriate treatment for patients suffering from MS.

Female patients and patients with young onset had longer median time to death but higher relative risk of dying compared with the corresponding population. PPMS had both shorter median time to death from onset and a higher relative risk of dying.

Hordaland County, Norway, has changed from a low-risk to a high-risk area for multiple sclerosis (MS) during the last 50 years. During the last 25 years, the incidence of MS has been stable rather than increasing. Systematic longitudinal follow-up studies are essential to calculate reliable prevalence and incidence rates in MS. The results suggest that both methodologic and environmental factors are essential in determining the distribution of MS.

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Bladder and sexual problems are associated with a marked reduction in the quality of life, also among patients with otherwise low disability. This underlines the need for identifying and treating these problems.

These findings suggest that patients with multiple sclerosis receiving fingolimod or natalizumab should be considered for a second dose of the vaccine in cases of insufficient protection. Our results further indicate that new immunomodulatory treatment regimens should be systematically evaluated for their influence on influenza-specific vaccine responses.

Background and Purpose-We sought to determine the incidence and short-term outcome of people aged 15 to 49 years with first-ever cerebral infarction in 1988 -1997 in Hordaland County, Norway. Methods-Cases were found from computer search of hospital registries and detailed review of patient records. Stroke subtype was classified according to the major intracranial artery affected. Short-term outcome was evaluated by the modified Rankin Scale (mRS). Results-A total of 96 women and 136 men met the inclusion criteria. The average annual incidence was 11.4/100 000.Women outnumbered men among those aged Ͻ30 years (Pϭ0.059); men predominated among those aged Ն30 years (Pϭ0.004). A total of 148 patients had anterior circulation infarction (64%), and 84 had posterior circulation infarction (36%) (PϽ0.001). Patients with posterior circulation infarction had better mRS score at discharge (Pϭ0.005). Eighty percent had favorable outcome (mRS score Յ2). The 30-day case fatality rate was 3.4%. The recurrence rate in hospital was 2.2%. Key Words: cerebral infarction Ⅲ incidence Ⅲ outcome Ⅲ young adults T he incidence of ischemic stroke increases with age, but the incidence among young adults is not negligible. We sought to determine the average annual incidence rate of first-ever cerebral infarction, classify stroke subtypes, and evaluate the short-term outcome of people aged 15 to 49 years in a well-defined population. To our knowledge, this is the first population-based report on short-term functional outcome of cerebral infarction in young adults. Conclusions-The Subjects and Methods PatientsAll patients aged 15 to 49 years with first-ever cerebral infarction during 1988 -1997 living in Hordaland County, Norway, for at least 5 years before the stroke occurred were included. Cases were found by computer search from hospital registries at each of the 5 acute care hospitals in the county. The searching criteria were patients admitted to either an inpatient or an outpatient department and discharged with a diagnosis of primary or secondary stroke: categories 430 to 438 of the International Classification of Diseases, Ninth Revision.Cerebral infarction was defined in accordance with the BaltimoreWashington Cooperative Young Stroke Study Criteria. 1 This definition includes patients who have neurological deficits lasting Ͼ24 hours because of ischemic lesions and patients with transient ischemic attacks in whom CT or MRI shows infarctions related to the clinical findings. We excluded patients with cerebral infarction associated with other intracranial diseases such as subarachnoid hemorrhage, sinus venous thrombosis, or severe head trauma. Case selection and classification were based on the examination of the neurologist in charge of treatment and follow-up of the patient as well as critical review of patient records.Stroke subtypes were categorized according to the intracranial artery involved on the basis of the neurological deficits and CT or MRI findings.Neurological deficits on admission and discharge were categorized into no...