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Editorial
peer-reviewed

Neuropsychiatry in Demyelination Disease: Using Depression as a Prodrome for Early Diagnosis and Treatment of Multiple Sclerosis



Abstract

Multiple sclerosis (MS) is an autoimmune disorder where the body attacks its own insulating myelin sheaths covering the nerve cells in the brain and spinal cord. MS patients show signs of mental illness via emotional blunting, liability, apathy, depression, irritability, and psychosis. Many psychiatrists have noted that the symptomatology of mood disorder is very similar to early signs of MS. The mechanism behind the relationship of depression with MS is not entirely understood at this point. However, through advancements in medical imaging techniques, there are now some leading explanations. One main explanation suggests that depression and memory disturbance are correlated to the demyelination within the limbic system caused by MS. Studies showed that following a diagnosis of MS, the rates of depression are significantly elevated in patients. Several studies noted a lifetime prevalence of major depression in >50% of MS patients. These studies foreshadow that depression is a very important clinical harbinger of active demyelination in MS patients. Depression may hint at which subgroup or stage the MS patient is in, without needing to wait for dramatic physical signs or symptoms to commence. Future physicians may be able to use depression as a prodrome for multiple sclerosis and narrow down the prognosis of their patients, treating them earlier.



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Editorial
peer-reviewed

Neuropsychiatry in Demyelination Disease: Using Depression as a Prodrome for Early Diagnosis and Treatment of Multiple Sclerosis


Author Information

Mrigank S. Shail Corresponding Author

School of Medicine, Xavier University School of Medicine


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


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Editorial
peer-reviewed

Neuropsychiatry in Demyelination Disease: Using Depression as a Prodrome for Early Diagnosis and Treatment of Multiple Sclerosis

Mrigank S. Shail">Mrigank S. Shail

  • Author Information
    Mrigank S. Shail Corresponding Author

    School of Medicine, Xavier University School of Medicine


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: November 01, 2017

    DOI

    10.7759/cureus.1813

    Cite this article as:

    Shail M S (November 01, 2017) Neuropsychiatry in Demyelination Disease: Using Depression as a Prodrome for Early Diagnosis and Treatment of Multiple Sclerosis. Cureus 9(11): e1813. doi:10.7759/cureus.1813

    Publication history

    Received by Cureus: August 13, 2017
    Peer review began: August 22, 2017
    Peer review concluded: October 28, 2017
    Published: November 01, 2017

    Copyright

    © Copyright 2017
    Shail. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Multiple sclerosis (MS) is an autoimmune disorder where the body attacks its own insulating myelin sheaths covering the nerve cells in the brain and spinal cord. MS patients show signs of mental illness via emotional blunting, liability, apathy, depression, irritability, and psychosis. Many psychiatrists have noted that the symptomatology of mood disorder is very similar to early signs of MS. The mechanism behind the relationship of depression with MS is not entirely understood at this point. However, through advancements in medical imaging techniques, there are now some leading explanations. One main explanation suggests that depression and memory disturbance are correlated to the demyelination within the limbic system caused by MS. Studies showed that following a diagnosis of MS, the rates of depression are significantly elevated in patients. Several studies noted a lifetime prevalence of major depression in >50% of MS patients. These studies foreshadow that depression is a very important clinical harbinger of active demyelination in MS patients. Depression may hint at which subgroup or stage the MS patient is in, without needing to wait for dramatic physical signs or symptoms to commence. Future physicians may be able to use depression as a prodrome for multiple sclerosis and narrow down the prognosis of their patients, treating them earlier.



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Mrigank S. Shail, M.D.

School of Medicine, Xavier University School of Medicine

For correspondence:
mrigank.shail@gmail.com

Mrigank S. Shail, M.D.

School of Medicine, Xavier University School of Medicine

For correspondence:
mrigank.shail@gmail.com