Neuroimmunology Section, Neurology Department, Ramos Mejia Hospital, Buenos Aires University, Argentina.
Psychiatry Department, Ramos Mejia Hospital, Buenos Aires, Argentina.
Mult Scler Relat Disord. 2018 Jan;19:40-43. doi: 10.1016/j.msard.2017.11.002. Epub 2017 Nov 7.
Neuromyelitis optica is a relapsing inflammatory, secondarily demyelinating astrocytopathy that most commonly affects the optic nerves and the spinal cord.
This study aimed to evaluate the psychopathological profile, presence of current depression, and suicidality in patients with neuromyelitis optica spectrum disorders (NMOSD) in an Argentinean cohort, and compare these parameters to those in patients with multiple sclerosis (MS) and in healthy controls (HCs).
Twenty patients with NMOSD, 18 with MS, and 20 healthy controls were included. The presence and grade of current depression were assessed using Beck's depression inventory (BDI), while psychiatric disease and suicidality were assessed using the Mini-International Neuropsychiatric Interview.
The prevalence of psychiatric disease in the NMOSD group was 45%, significantly higher than in the MS group (16%, p = 0.06) and the HCs (5%, p = 0.008). Recurrent major depressive disorder was the most frequent psychiatric disease and was diagnosed in four (20%) patients in the NMOSD group and in two (11%) patients in the MS group. In the NMOSD group, two (10%) patients were diagnosed with past manic episodes, one (5%) with current dysthymic disorder, one (5%) with lifetime psychotic disorder, and one (5%) with bulimia nervosa. One patient (5.5%) in the MS group and one in the HC (5%) were diagnosed with current generalized anxiety disorder. Ten patients (50%) in the NMOSD group had current depressive symptoms versus five (28%) patients in the MS group (p = 0.16) and two (10%) in the HC group (p = 0.02). Six (30%) patients with NMOSD versus only one (5.5%) patient with MS had attempted suicide at least once, this difference was statistically significant (p = 0.05). Current suicide risk was high in patients with NMOSD (8, 40%) and moderate in patients with MS (4, 22%).
Our study shows that the prevalence of psychiatric comorbidities in patients with NMOSD is significantly higher than in patients with MS and healthy controls. Given the high frequency of suicidality, assessment of pertinent psychiatric disorders in such patients to optimize monitoring and comprehensive treatment is required.
视神经脊髓炎是一种复发性炎症性、继发性脱髓鞘星形胶质病，最常影响视神经和脊髓。
本研究旨在评估阿根廷队列中视神经脊髓炎谱系疾病（NMOSD）患者的精神病理学特征、当前抑郁的存在和自杀倾向，并将这些参数与多发性硬化症（MS）患者和健康对照组（HCs）进行比较。
纳入 20 例 NMOSD 患者、18 例 MS 患者和 20 例健康对照者。使用贝克抑郁量表（BDI）评估当前抑郁的存在和严重程度，使用 Mini-国际神经精神访谈评估精神疾病和自杀倾向。
NMOSD 组的精神疾病患病率为 45%，明显高于 MS 组（16%，p=0.06）和 HCs（5%，p=0.008）。复发性重度抑郁症是最常见的精神疾病，在 NMOSD 组的 4 名（20%）患者和 MS 组的 2 名（11%）患者中诊断。在 NMOSD 组中，2 名（10%）患者被诊断为过去的躁狂发作，1 名（5%）患者被诊断为当前心境恶劣障碍，1 名（5%）患者被诊断为终生精神病性障碍，1 名（5%）患者被诊断为神经性贪食症。MS 组中有 1 名（5.5%）患者和 HCs 中有 1 名（5%）患者被诊断为当前广泛性焦虑障碍。NMOSD 组中有 10 名（50%）患者存在当前抑郁症状，而 MS 组中有 5 名（28%）患者（p=0.16）和 HCs 组中有 2 名（10%）患者（p=0.02）。NMOSD 组中有 6 名（30%）患者至少尝试过一次自杀，而 MS 组中只有 1 名（5.5%）患者，差异有统计学意义（p=0.05）。NMOSD 患者当前自杀风险较高（8 例，40%），MS 患者为中度（4 例，22%）。
我们的研究表明，NMOSD 患者的精神共病患病率明显高于 MS 患者和健康对照者。鉴于自杀率较高，需要对这些患者进行相关精神障碍评估，以优化监测和综合治疗。
