[Psychological changes in multiple sclerosis].

In dealing with our multiple sclerosis (MS) patients concomitant and consecutive symptoms of a psychical nature also deserve appropriate consideration in addition to the variety of somatic symptoms. In the following synopsis, numerous and in part divergent findings - observations, hospital statistics as well as psychodiagnostic test results - concerning the psychopathology of MS are presented. A multiplicity of mental changes, depending upon the variability of the disease process and its course, can be noticed. Over the past century euphoria was long regarded as the psychopathological trait of MS. Along with transitions in patient populations in the meantime hardly more euphoric than depressive moods are registered. Euphoric mood aberrations are to be regarded as substrate dependent disturbances, which deteriorate parallel to disease duration and severity. Intellectual dysfunctions as well as topical brain symptoms (so-called "instrumental disabilities"), obsessive laughing and crying also reflect the basic organic process. Concerning other symptoms such as depression or dysphoria, emotional lability or lack of drive, at its extreme apathy, one cannot definitely determine to what extent - in view of a multidimensional approach - these are to be regarded as mental correlates of the disease process, or as individual reactions to the disease along with considerable social consequences. Psychoses, rarely occurring in MS, can be classified either as organic, or, in seldom cases, as a fortuitous coincidence of MS and endogenous psychosis.