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Neuropsychiatric symptoms are common in multiple sclerosis (MS). They include two broad categories of disturbances: abnormalities in cognition, and abnormalities of mood, affect and behaviour. The present review deals with the epidemiology, clinical features, etiology and treatment of disturbances included in the second category, i.e., major depression, fatigue and sleep disorders, bipolar disorder, euphoria, pathological laughing and crying, anxiety, psychosis and personality changes. Major depression is one of the most common neuropsychiatric disorders in MS with an approximate 50% lifetime prevalence rate. Early recognition and management of depression in MS is of major importance because it is a key predictor of morbidity, mortality, quality of life, possibly physical outcome and disease exacerbations, adherence to immunomodulatory treatments and suicide risk in MS patients, as well as of the caregiver's distress and quality of life. The etiopathogenesis of neuropsychiatric disorders in MS has been incompletely investigated. It is postulated that a complex interplay of biological, disease-related, behavioural and psychosocial factors contribute to the pathophysiology of most of them. Management of neuropsychiatric symptoms in MS is often effective, although commonly based on evidence provided by case studies and uncontrolled trials. A comprehensive biopsychosocial neuropsychiatric approach is essential for the optimal care of patients with MS.

Background: Internet addiction disorder is excessive computer use that interferes with daily life. There is debate over whether or not to include it as a diagnosis in the next DSM edition. We present a case of a 24-year-old woman who although not meeting criteria for addiction was referred to our clinic due to excessive use of social networks which severely interfered her daily life. Case report: A woman presented to our clinic accompanied by her parents because she had been spending approximately 5 hours/day checking her facebook webpage. She had subscribed to facebook 8 months before her examination and already had over 400 webfriends. During the previous 7 months, she ceased several of her activities, remained home most of the day in order to check her facebook and lost her job as a waitress because she repeatedly left her post in order to go to the nearest internet café. Noteworthy, during her examination she took out her mobile phone and tried to establish an internet connection and check facebook. On clinical examination mild anxiety, sleep disturbances were present, but she refused any further psychotherapeutic or pharmacotherapeutic help. Discussion: According to the prevailing view regarding addiction, facebook addiction can be considered as an "urge-driven disorder" with a strong compulsive component. Although our patient had been using internet for the past 7 years she had never been previously addicted to internet use. We suggest that facebook addiction may be another subcategory of the internet spectrum addiction disorders.