Depression in Multiple Sclerosis: A Review of Assessment and Treatment Approaches in Adult and Pediatric Populations

Σκώκου, Μαρία; Soubasi, Evanthia; Gourzis, Philippos

doi:10.5402/2012/427102

Cited by 67 publications

(60 citation statements)

References 92 publications

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“…Thirty six percent of the MS patients included in the study had spasticity and their pain score was higher than the group without spasticity (p=0.001). Depression is seen in 19-54% of MS patients (30). This prevalence is due to both the nature of the disease and the modifying treatment, especially interferon.…”

Section: Discussionmentioning

confidence: 99%

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Akpınar¹,

Tokgöz²,

Gümüş³

2014

tnd

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Objective: Multiple sclerosis (MS) is an autoimmune-neurodegenerative disease of the central nervous system. The prevalence of pain is between 29% and 86% and besides neuropathic pain, somatic pain types may also emerge together or separately. In this study we aimed to analyze the relationship between pain and other clinical features in MS. Ma te ri als and Met hods: One-hundred cases who were followed in MS clinic and who have complaints of pain, were included in this study. We evaluated pain type and localization during patients were filling in the forms. We applied Visual Pain Scale (VPS), Ashworth Spasticity Scale (ASS) and Beck Depression Scale (BDS). Re sults: When female and male patients were compared, there were no statistical differences between age, disease duration and EDDS scores. Seventy seven percent of cases complained of neuropathic pain, 21% of cases had Lhermitte symptoms. Trigeminal neuralgia has been observed in 1% of cases and 55% of neuropathic extremity pain. In 60% of the cases nociceptive pains, in 12% of the cases joint-extremity-muscle pain, in 47% headache and in 1% painful tonic spasms were present. Pain depending on the treatment was observed only in 2% of the cases. The pain score was high in patients with spasticity and depression. Although there was reasonable positive correlation between age, EDDS score and VPS, poor correlation was obtained between disease period and number of attacks. Conclusion: These findings indicate that MS pain is related with spasticity, disability and depression and these clinical findings should be taken into account during pain treatment. (Turkish Journal of Neurology 2014; 20:79-83) Key Words: Multiple sclerosis, pain, neuropathic pain, headache, trigeminal neuralgia Amaç: Multipl Skleroz (MS), santral sinir sisteminin otoimmün-nörodejeneratif bir hastalığıdır. Ağrı prevalansının %29-%86 arasında değiştiği bu hastalıkta nöropatik, somatik ağrı tipleri bir arada veya tek olarak ortaya çıkabilir. Bu çalışmada MS'te ağrı ve diğer klinik özellikler arasındaki ilişkiyi araştırmayı amaçladık. Ge reç ve Yön tem: Çalışmaya MS polikliniğinde takip edilen ve ağrı şikayeti olan 100 olguyu dahil ettik. Olgulara hazırladığımız anket formunu doldurtarak ağrı tipi ve lokalizasyonunu sorguladıktan sonra Vizüel Ağrı Skalası (VAS), Ashworth Spastite Skalası (ASS) ve Beck Depresyon Ölçeği (BDÖ) uyguladık. Bulgular: Kadın ve erkek hastalar karşılaştırıldığında yaş, hastalık süresi, atak sayısı, EDSS skorları arasında istatistiksel olarak anlamlı fark yoktu. Olguların %77'sinde nöropatik ağrı; %21'inde Lhermitte belirtisi, %1'inde trigeminal nevralji, %55'inde nöropatik ekstremite ağrısı vardı. Olguların %60'ında nosiseptif ağrı; %12'sinde yaygın eklem-ekstremite kas ağrısı, %47'sinde baş ağrısı, %1'inde ağrılı tonik spazm mevcuttu. Olguların sadece %2'sinde tedaviye bağlı ağrı vardı. Ağrı skoru, spastisitesi ve depresyonu olanlarda anlamlı derecede yüksekti. Yaş ve EDSS skoru ile VAS arasında orta derecede pozitif korelasyon varken, hastalık süresi ve atak sayısı ile...

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Section: Discussionmentioning

confidence: 99%

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Akpınar¹,

Tokgöz²,

Gümüş³

2014

tnd

View full text Add to dashboard Cite

show abstract

“…Improved mood, better relaxation, increased motor activity in music listening group (P < 0.0001) Kim et al [76] CCT (0) [78] CCT (0) Reduction of depression (P = 0.002) and fatigue (P = 0.02) and improvement in the synchronization tapping (P < 0.05) 1 Subjects expressing a clear preference for treatment (25% of total) were allocated to music therapy while all others were randomly assigned to either treatment or control group; 2 The goal of random assignment was not fully achieved because of the need to have 2-3 subject available at the same time to held group session in the treatment condition; 3 Subjects heard 1 min of music or noise and after were given all assessments while they were continuously exposed to the sound up to the end of the evaluation; 4 Patients were quasi-randomly assigned to groups making sure that the two groups were as close as possible in terms of numerosity and clinical characteristics of participants. …”

Section: Analysis Of Patient's Interviewsmentioning

confidence: 99%

“…However, the reductionism of Combe's distinction clearly emerges from the clinical observation given that a wide range of nervous system's illnesses with different etiology shows both neurological and psychiatric symptoms. Emotional and behavioral disturbances with a polymorphic symptomatology are often connected to neurological disorders such as Multiple Sclerosis (MS) [1][2][3] , Parkinson' s Disease (PD) [4] , stroke [5] , dementia [6] , traumatic brain injury [7] , epilepsy [8,9] , Amyotrophic Lateral Sclerosis (ALS) and others Motor Neuron Diseases (MND) [10,11] , pain syndromes (like headaches) and can be observed even with or without "organic" neurological diseases, thus miming in some cases an idiopathic psychiatric disorder.…”

Section: Neurology and Psychiatrymentioning

confidence: 99%

Effects of music and music therapy on mood in neurological patients

Raglio

Attardo

Gontero

et al. 2015

WJP

156

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Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders with a prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson's disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy (MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on PubMed and PsycInfo databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson's Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients.

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“…Sıklıkla görülmesi, artmış suisid riski ve hastalık seyri, kognitif fonksiyon, tedavi uyumu ve yaşam kalitesi üzerine kötü etkisi düşünüldüğünde MS'de depresyonun değerlendirilmesi ve tedavi edilmesindeki önem ortaya çıkmaktadır. [26] Literatürde MS hastalarında sıklıkla birlikte görülen semptomlar olan ağrı ve depresyon arasındaki ilişkiyi inceleyen çalışmaların sonuçları çelişkilidir. Multipl sklerozda beyin ve spinal kordda ağrı ve depresyonda rol oynayan somatosensoriyal yolakların atrofiye ve demiyelinizasyona uğradığı öne sürülmektedir.…”

Section: Discussionunclassified

The assessment of pain in patients with multiple sclerosis and its association with quality of life, fatigue, and depression

Güven¹

2016

Turk J Phys Med Rehab

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Bulgular: Hastaların %70.2'sinde son bir ay içinde ağrı yakınması vardı. Ağrı en sık, uyuşma veya karıncalanma (35.6%) şeklinde bacaklarda (%80.8) lokalize idi. En sık ağrı tipi dizestetik ekstremite ağrısı (%47.9) idi. Ağrı tipinin sınıflandırmasına göre, en sık ağrı tipi, mikst tip ağrı (nöropatik ve nöropatik olmayan) (%57.5) idi. Ağrısı olan ve olmayan gruplar arasında depresyon şiddeti açısından anlamlı bir fark saptanmadı (p>0.05). Ağrılı hastalarda ortalama YŞÖ skoru ve yorgunluk düzeyi daha yüksek bulundu (p<0.001). Kısa Form-36 değerlendirmesine göre, ağrısız hastalarda fiziksel fonksiyon hariç tüm parametrelerde istatistiksel olarak anlamlı bir yükseklik tespit edildi (p<0.05). Sonuç:Multipl sklerozlu hastalarda çok yaygın bir semptom olan ağrıya yönelik farkındalık artırılmalıdır. Her MS hastası, ağrı varlığı ve özelliği açısından değerlendirilmelidir. MS'li hastalarda ağrıya yönelik etkin tedavi yorgunluk şiddetini azaltmaya ve yaşam kalitesini iyileştirmeye yardımcı olacaktır.Anahtar sözcükler: Depresyon; yorgunluk; multipl skleroz; ağrı; yaşam kalitesi. ABSTRACTObjectives: This study aims to evaluate pain and triggering factors in patients with multiple sclerosis (MS) and to investigate the relation between pain and quality of life, fatigue, and depression. Patients and methods:Between January 2010 and March 2012, a total of 104 patients (33 males, 71 females; mean age 39.06+9.01 years; range, 18 to 62 years) who were diagnosed with definite MS according to the McDonald diagnostic criteria were enrolled to our study. The patients were questioned about the presence of pain and divided into two groups as those with (n=73) and without (n=31) pain. The patients with pain were assessed for the pain duration, intensity, quality, localization, type, classification, and triggering factors. The visual analog scale (VAS), Short Form-36 (SF-36), Beck Depression Inventory (BDI), and Fatigue Severity Scale (FSS) were used as clinical assessment scales.Results: Of the patients, 70.2% had a complaint of pain within the past month. Pain was most frequently localized in the legs (80.8%) with numbness or tingling (35.6%). The most common type of pain was dysesthetic extremity pain (%47.9). According to the classification of the pain type, the mixed type (neuropathic and non-neuropathic) pain was the most common type of pain (%57.5). There was no significant difference in the depression severity between the groups with and without pain (p>0.05). The mean FSS scores and level of fatigue were significantly higher in the patients with pain (p<0.001). Based on the evaluation of the SF-36, all parameters except the physical functioning were found to be statistically significantly higher in patients without pain (p<0.05). Conclusion:The awareness on pain, a common symptom in MS patients, should be increased. Every MS patient should be evaluated for the presence and characteristic of pain. Therefore, an effective treatment of pain will help to reduce the severity of fatigue and improve the quality of life in MS patients.

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Depression in Multiple Sclerosis: A Review of Assessment and Treatment Approaches in Adult and Pediatric Populations

Cited by 67 publications

References 92 publications

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

Effects of music and music therapy on mood in neurological patients

The assessment of pain in patients with multiple sclerosis and its association with quality of life, fatigue, and depression

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