Depression in multiple sclerosis

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. (C) 2009 Elsevier Masson SAS. All rights reserved.