Lebrun C, Cohen M
Service de neurologie, Hôpital Pasteur, Nice.
Rev Neurol (Paris). 2009 Mar;165 Suppl 4:S156-62. doi: 10.1016/S0035-3787(09)72128-9.
Mood disturbance and depression occur in more than half of multiple sclerosis patients. It can be diagnosed in established cases, although it can be present early in the disease course. Depression is not clearly related to specific MS brain lesions but is frequently associated with other symptoms such as fatigue or cognitive impairment. Depression in MS is more frequent than in an age-matched population or in other chronic diseases. There seems to be an elevated risk of suicide. Immunomodulatory treatments do not interfere with depression, but the screening for depression and monitoring of mood should be a feature of the medical management of all patients with MS, regardless of whether they are receiving interferon. MS patients respond well to treatment, either psychotherapy or antidepressants.
超过半数的多发性硬化症患者会出现情绪障碍和抑郁。在确诊病例中可以作出诊断,尽管其可能在病程早期就已出现。抑郁与特定的多发性硬化症脑部病变并无明确关联,但常与疲劳或认知障碍等其他症状相关。多发性硬化症患者中的抑郁比年龄匹配的人群或其他慢性疾病患者更为常见。自杀风险似乎有所升高。免疫调节治疗不会干扰抑郁状况,但对所有多发性硬化症患者进行抑郁筛查和情绪监测应是医疗管理的一项内容,无论他们是否正在接受干扰素治疗。多发性硬化症患者对心理治疗或抗抑郁药物治疗反应良好。