Minden S L
Brigham and Women's Hospital, Division of Psychiatry, 75 Francis Street, Boston, Massachusetts, MA 02115, USA.
J Neurovirol. 2000 May;6 Suppl 2:S160-7.
Emotional disturbances are common in MS and consist of disturbances of mood and disturbances of affect. The important mood disorders are major depressive disorder, dysthymic disorder, bipolar disorder, panic disorder, and generalized anxiety disorder. Their relationship to MS is multi-factorial and complex, and the extent to which they are direct consequences of the disease process or psychological reactions to it remains unclear. Whatever their cause, however, the symptoms of mood disorders in people with MS are no different from the symptoms of mood disorders in people without MS, and respond just as well to standard treatments. The disorders of affect are euphoria, pathological laughing and weeping, and other frontal lobe syndromes. These disorders result from demyelination, are some of the most characteristic symptoms of MS, and have the same implications for treatment as do other aspects of the disease. Mood and affective disturbances can cause enormous pain and suffering and lead to significant disruption of family, work, and social life. Physicians who can identify, diagnose, treat, and manage mood and affective disturbances effectively and who can help their patients and family members acknowledge these difficulties, talk about them, and accept psychiatric consultation and treatment can have a dramatic impact on the quality of their lives. This paper outlines the symptoms and diagnostic criteria for mood disorders and affective disturbances, reviews current treatment options, summarizes data from epidemiologic and pathophysiological studies, and suggests areas for future research.
情感障碍在多发性硬化症（MS）中很常见，包括情绪障碍和情感障碍。重要的情绪障碍有重度抑郁症、心境恶劣障碍、双相情感障碍、惊恐障碍和广泛性焦虑障碍。它们与MS的关系是多因素且复杂的，其在多大程度上是疾病过程的直接后果或对该疾病的心理反应仍不清楚。然而，无论其病因如何，MS患者的情绪障碍症状与非MS患者的情绪障碍症状并无不同，对标准治疗的反应也相同。情感障碍包括欣快、病理性哭笑及其他额叶综合征。这些障碍由脱髓鞘引起，是MS最具特征性的一些症状，对治疗的影响与该疾病的其他方面相同。情绪和情感障碍会造成巨大的痛苦，并导致家庭、工作和社会生活的严重混乱。能够有效识别、诊断、治疗和管理情绪及情感障碍，并能帮助患者及其家庭成员认识到这些困难、谈论这些困难并接受精神科咨询和治疗的医生，会对他们的生活质量产生巨大影响。本文概述了情绪障碍和情感障碍的症状及诊断标准，回顾了当前的治疗选择，总结了流行病学和病理生理学研究的数据，并提出了未来研究的方向。
