Depression and hypomania symptoms are associated with high dose corticosteroids treatment for MS relapses

Morrow, Sarah A.; Barr, Jennifer; Rosehart, Heather; Ulch, Sandra

doi:10.1016/j.jad.2015.08.040

Cited by 18 publications

(9 citation statements)

References 25 publications

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“…Depression can also be related to drug and alcohol abuse, which can further exacerbate motor and cognitive impairments during relapse (54). Furthermore, screening for depression both prior to and after treatment is critical when administering high dose corticosteroids for relapse, as these drugs have been associated with increased risk of attempted suicide (55). Alleviating depressive symptoms through a combination of antidepressants (56) and cognitive behavioral therapy (57) can help with symptom relief in some patients.…”

Section: Comorbiditiesmentioning

confidence: 99%

Emerging Approaches for Validating and Managing Multiple Sclerosis Relapse

2017

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The autoimmune disease multiple sclerosis (MS) is characterized by relapses in the majority of patients. A definitive clinical diagnosis of relapse in MS can be complicated by the presence of an infection or comorbid disorder. In this mini-review, we describe efforts to develop enhanced imaging techniques and biomarker detection as future tools for relapse validation. There is emerging evidence of roles for meningeal inflammation, sex hormones, comorbid metabolic or mood disorders, and a dysregulated immune profile in the manifestation and severity of relapse. Specific subsets of immune cells likely drive the pathophysiology of relapse, and identification of a patient’s unique immunological signature of relapse may help guide future diagnosis and treatment. Finally, these studies highlight the diversity in terms of relapse presentation, immunological signature, and response in patients with MS, indicating that going forward the best approach to assessment and treatment of relapse will be multifactorial and highly personalized.

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Section: Comorbiditiesmentioning

confidence: 99%

Emerging Approaches for Validating and Managing Multiple Sclerosis Relapse

2017

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“…Depression and MS likely have a bidirectional relationship; prior studies have found complex associations with inflammatory markers, 34 lesion volume/ location and atrophy, 35 effects of MS treatments, 36 and disease-related disability, 6,37 among other factors. Continued research on the relationship between these entities could offer insight into MS physiology and increase motivation for providers and patients to address modifiable behaviors.…”

Section: Discussionmentioning

confidence: 99%

Depression readmission risk is elevated in multiple sclerosis compared to other chronic illnesses

et al. 2021

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Objective: Assess readmissions for depression or suicide attempt (SA) after MS admission versus other chronic inflammatory illnesses. Methods: This retrospective cohort study identified MS, asthma, rheumatoid arthritis (RA), depression, and SA in the 2013 National Readmissions Database by International Classification of Diseases codes. Index admissions (MS, n = 7698; asthma, n = 93,590; RA, n = 3685) and depression or SA readmission rates were analyzed. Hazard ratios (HRs) estimated 1-year depression/SA readmission hazard, comparing MS to asthma or RA, adjusting for age, sex, psychiatric comorbidity, substance abuse, tobacco use, income, and index hospitalization characteristics. Results: MS had more baseline depression (24.7%) versus asthma (15.6%) and RA (14.6%). Ninety-day depression readmission rate was higher in MS (0.5%) than asthma (0.3%) and RA (0.03%). Depression readmission HR was higher after MS admission versus asthma (HR = 1.37, 95% confidence interval (CI) = 1.00–1.86, p = 0.0485) and RA (HR = 4.68, 95% CI = 1.60–13.62, p = 0.0047). HR was not different for SA readmission across groups. Depression readmission HR was more than double in MS patients with psychiatric disease or substance abuse versus RA or asthma patients with either comorbidity. Conclusion: Depression readmission risk after MS hospitalization was elevated versus asthma/RA. Substance use and baseline psychiatric comorbidity were more strongly associated with depression readmission in MS patients.

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“…Les troubles psychiatriques cortico-induits sont très variés et peuvent balayer un champ très large de la pathologie psychiatrique [4]. Insomnie, anxiété, troubles cognitifs, troubles de l'humeur, idées suicidaires, agitation, état confusionnels [2,5,6]. Ces manifestations psychiatriques ont été décrites depuis plus d'une soixantaine d'années par Rome et Braceland [7] et classées en quatre différents stades: 1) le premier se traduit par une certaine euphorie, une baisse du sentiment de fatigue avec une impression de facilité intellectuelle qui peuvent passer inaperçues; 2) au second stade les signes psychiques deviennent plus marqués avec une excitation et une insomnie.…”

Section: Discussionunclassified

Corticoïdes et culture: un cas d'épisode psychotique aigu cortico-induit

et al. 2019

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Les effets secondaires psychiatriques des corticoïdes sont décrits depuis longtemps. Certaines réactions sont sévères et concernent environ 5% des patients. Ces effets secondaires sont plus difficiles à évaluer lorsque le recours aux corticoïdes sort du cadre thérapeutique habituel et s'intègre dans une automédication en lien avec certaines influences culturelles. Nous rapportons le cas d'une jeune femme ayant présenté un épisode psychotique aigu dans les suites d'une auto-prise de corticoïdes dans un but de gain de poids. Nous discutons l'intérêt d'un diagnostique et d'une prise en charge précoce ainsi que l'importance du volet préventif multidisciplinaire, en particulier devant l'implication de l'aspect culturel dans l'observation présentée.

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Depression and hypomania symptoms are associated with high dose corticosteroids treatment for MS relapses

Cited by 18 publications

References 25 publications

Emerging Approaches for Validating and Managing Multiple Sclerosis Relapse

Emerging Approaches for Validating and Managing Multiple Sclerosis Relapse

Depression readmission risk is elevated in multiple sclerosis compared to other chronic illnesses

Corticoïdes et culture: un cas d'épisode psychotique aigu cortico-induit

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