An Investigation into some Psychiatric Aspects of Multiple Sclerosis

Surridge, David

doi:10.1192/bjp.115.524.749

Cited by 270 publications

(105 citation statements)

References 67 publications

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“…Although a few investigators have deemed depression in MS patients to be 'reactive' to the illness [25,26], others have believed that it results from the presence of demyelinating lesions in limbic areas of the brain, which control mood and emotion [27,28]. The finding that depression may be worse at the time of elevated disease activity [29] as well as being correlated with physical disability [30] supports the view that organic etiology underlies MS patients' depression.…”

Section: Characteristics Of Elevated Suicide Risksupporting

confidence: 65%

Elevated Suicide Risk among Patients with Multiple Sclerosis in Sweden

et al. 2003

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Results from previous studies of suicide risk among patients with multiple sclerosis (MS) are inconsistent. This may be explained partly by differences in methodology and study populations. The purpose of our study was to investigate suicide risk among hospital patients with MS in Sweden. During the period 1969–1996, 12,834 cases were recorded in the Swedish Hospital Inpatient Register, with 77,377 hospital admissions, in which MS was a primary or secondary diagnosis at discharge. The mean follow-up time for the whole cohort was 9.9 (SD 7.3) years. When the data for these MS patients were linked to the Swedish Causes of Death Register for the same period, 5,052 (39.4%) were found to have died. Among the 5,052 deaths, suicide was an underlying cause of death in 90 cases (1.8%). The mean period between the initial admission date with an MS diagnosis at discharge and the date of death for the 90 MS suicide cases was 5.8 (SD 5.1) years. This was significantly shorter (p = 0.002) than the mean of 7.9 (SD 6.4) years for MS cases who died due to other causes. Suicide risk, calculated as the standardized mortality ratio (SMR), was significantly elevated (SMR = 2.3) among both male and female MS cases compared with the general population. Suicide risk was particularly high in the first year after initial admission with an MS diagnosis, and among younger male MS cases. The mean age at the time of suicide was 44.5 (SD 12.4) years, and 58% of the suicides were committed within 5 years after the first admission with an MS diagnosis. The crude suicide rate among MS patients during the study period was 71 per 100,000 person-years. The rate was significantly higher (p < 0.001) in males (114) than in females (47), with an odds ratio of 2.4 (95% CI: 1.6–3.8). These findings have implications for suicide preventive measures in neurological practice.

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Section: Characteristics Of Elevated Suicide Risksupporting

confidence: 65%

Elevated Suicide Risk among Patients with Multiple Sclerosis in Sweden

et al. 2003

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“…Emotionalism has been described in association with a wide variety of brain pathologies particularly stroke (House et at., 1989), multiple sclerosis (Surridge, 1969), motor neurone disease (Gallagher, 1989), and cerebral tumour (Wilson, 1924). Crying or laughing occasionally occurs as part of the ictus in epilepsy (dacrystic and gelastic epilepsy respectively) (Offen et at., 1976;Sethi and Rao, 1976) and even less commonly as a dramatic presenting feature in patients with brain stem pathology (Fere, 1903).…”

Section: Aetiologymentioning

confidence: 99%

Emotionalism Following Brain Damage

Allman

1991

Behavioural Neurology

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Emotionalism is an heightened tendency to cry, or more rarely, laugh. It is commonly associated with brain damage and is often distressing to both patients and carers. Emotionalism is easily confused with depression, and when severe it can interfere with treatment. The aetiology is poorly understood but its response to drugs with different modes of action suggests that there is more than one underlying mechanism. When the components of emotionalism are studied separately a wide range is observed and they combine in a more complex and varied way than commonly held stereotyped views suggest. Most patients with emotionalism are helped by simple education and reassurance. Some severe cases respond dramatically to tricyclic antidepressants, levodopa or fluoxetine.

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“…Esse mesmo estudo demonstrou que o IEED está associado a estágios mais avançados da doença, quando já existe incapacidade física e mental, o que foi compatível com outros relatos prévios (Surridge, 1969).…”

Section: Epidemiologiaunclassified

Transtorno da expressão emocional involuntária

Sartori¹,

Barros

Tavares³

2008

Rev. psiquiatr. clín.

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Contexto: O transtorno da expressão emocional involuntária (involuntary emotional expression disorder ou IEED)consiste em um transtorno do afeto, caracterizado por uma dificuldade em controlar a expressão emocional, que se apresenta por episódios breves e estereotipados de riso e/ou choro incontroláveis. Pode estar relacionado a diversas patologias encefálicas, em variadas localizações anatômicas. Objetivos: Revisar aspectos clínicos, epidemiológicos e fisiopatológicos envolvidos no transtorno da expressão emocional involuntária e apresentar as opções atuais e futuras na abordagem terapêutica. Métodos: Pesquisa de base de dados MEDLINE/PUBMED e LILACS utilizando os termos transtorno da expressão emocional involuntária, afeto pseudobulbar, riso e choro patológicos, acidente vascular cerebral, doença de Alzheimer, esclerose múltipla, esclerose lateral amiotrófica. Resultados: No trantorno da expressão emocional involuntária, as crises de choro e/ou riso, além de serem incontroláveis, tendem a ser desproporcionais ao estímulo recebido, podendo estar completamente dissociada do estado de humor do paciente ou mesmo ser contraditória ao contexto no qual o estímulo está inserido. Outros termos são usados na nosografia desse transtorno, como afeto pseudobulbar, riso e choro patológicos, labilidade emocional, emocionalismo e desregulação emocional. Termos como choro forçado, choro involuntário, emocionalidade patológica e incontinência emocional também têm sido utilizados com menor freqüência. Os mecanismos fisiopatológicos específicos envolvidos nesse transtorno ainda não estão bem esclarecidos. Lesões que podem causá-lo estão amplamente distribuídas no encéfalo, mas parecem envolver o lobo frontal, o sistema límbico, o tronco cerebral e o cerebelo, assim como a substância branca que interconecta essa rede. Seu principal diagnóstico diferencial é a depressão. As terapias farmacológicas hoje disponíveis se baseiam em inibidores seletivos de recaptação de serotonina (ISRS), antidepressivos tricíclicos e, em menor extensão, em drogas dopaminérgicas. O composto AVP-923 está sendo estudado como um possível tratamento específico. Conclusão: Apesar de ser conhecido há séculos, ainda que sob diferentes nomenclaturas, o IEED permanece subdiagnosticado e, considerando a possibilidade dos efeitos deletérios desse transtorno no funcionamento social, ocupacional e familiar do paciente acometido, seu reconhecimento e conduta adequados são decisivos para possibilitar uma melhoria na qualidade de vida do paciente. , H.C.S. et al. / Rev. Psiq. Clín 35 (1); 20-25, 2008 Palavras-chave: Transtorno da expressão emocional involuntária, afeto pseudobulbar, riso e choro patológicos, acidente vascular cerebral, doeça de Azheimer, esclerose múltipla, esclerose lateral amiotrófica. Sartori AbstractBackground: Involuntary emotional expression disorder (IEED) is an affect disturbance caracterized by a difficulty of controlling emotional expression, that is presented as short, stereotyped and uncontrollable episodes of laugh-

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An Investigation into some Psychiatric Aspects of Multiple Sclerosis

Cited by 270 publications

References 67 publications

Elevated Suicide Risk among Patients with Multiple Sclerosis in Sweden

Elevated Suicide Risk among Patients with Multiple Sclerosis in Sweden

Emotionalism Following Brain Damage

Transtorno da expressão emocional involuntária

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