3rd Department of Psychiatry, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece.
Curr Opin Psychiatry. 2011 Jul;24(4):336-40. doi: 10.1097/YCO.0b013e328347341d.
The higher prevalence of psychiatric disorders in multiple sclerosis (MS) compared with the general population is well documented, with depression being the leading disorder. Apart from depression, other psychiatric disorders and symptoms such as bipolar disorder, pseudobulbar affect, euphoria sclerotica, anxiety and personality changes are also reported to be overpresented in MS patients. Psychiatric disorders in MS lead to significant disruption in patients' family, work and social life, affecting patients' quality of life in general. Moreover, they are reported to be associated with poorer adherence to MS medication. The literature concerning bipolar disorder and affect disorders in MS is rather scarce. The purpose of this article is to provide a critical review on the latter subject.
This review focuses upon the recent findings with regard to the epidemiology and the comorbidity rates of bipolar and affect disorders in MS, questions raised about the potential underlying mechanisms that could explain such a high comorbidity, diagnostic issues and the recent developments in the treatment of those psychiatric disorders in MS.
Despite the fact that the higher prevalence of psychiatric disorders in MS is well established, such disorders still remain underdiagnosed and undertreated. A shift in the clinical suspicion towards the psychiatric morbidity in MS patients and the optimal treatment of those disorders is fundamental.
多发性硬化症（MS）患者的精神障碍比普通人群更为常见，这一现象已被充分证实，其中抑郁症是最主要的精神障碍。除了抑郁症，其他精神障碍和症状，如双相情感障碍、假性延髓性麻痹、欣快性硬皮病、焦虑和人格改变，也被报道在 MS 患者中更为常见。MS 患者的精神障碍严重影响了他们的家庭、工作和社交生活，普遍降低了患者的生活质量。此外，它们与 MS 药物治疗的依从性较差有关。关于 MS 中的双相情感障碍和情感障碍的文献相当有限。本文的目的是对后者进行批判性综述。
这篇综述主要关注 MS 中双相和情感障碍的流行病学和共病率的最新发现，提出了一些关于潜在机制的问题，这些机制可以解释如此高的共病率，以及诊断问题和这些精神障碍在 MS 中的治疗新进展。
尽管多发性硬化症患者中精神障碍的高患病率已得到充分证实，但这些障碍仍未得到充分诊断和治疗。对 MS 患者精神疾病的临床怀疑需要转变，对这些疾病进行最佳治疗至关重要。
