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Depression in multiple sclerosis: a review

Department of Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand

Correspondence to:
Correspondence to:
R J Siegert
Rehabilitation Teaching and Research Unit, Department of Medicine, Wellington School of Medicine, University of Otago, PO Box 7343, Wellington South, New Zealand; rsiegert{at}wnmeds.ac.nz

Several studies have reported high rates of depression in multiple sclerosis (MS) with a lifetime prevalence of 50% and an annual prevalence of 20% not uncommon. Concern about the potential of new drug treatments to exacerbate or precipitate depression in MS has led to increased interest in the relation between MS and depression. This review on MS and depression identifies the following key issues: How common is depression in people with MS? Is depression in MS associated with lesions in specific regions of the central nervous system? Is there an increased risk of suicide in MS? Is there a higher than expected incidence of anxiety disorders in MS? Are fatigue and depressed mood related in MS? Is there a relation between depression and cognitive impairment in MS? Which psychosocial variables affect the development of depression in MS? Does treatment with interferon increase the risk of depression? How effective are treatments for MS patients with depression? Each of these issues is briefly reviewed with critical commentary, and some priorities for future research are suggested.

Abbreviations: BDI, Beck Depression Inventory; CBT, cognitive behavioural therapy; CES-D, Centre for Epidemiological Studies’ Depression Scale; MS, multiple sclerosis; SSRI, selective serotonin reuptake inhibitor

Keywords: multiple sclerosis; depression

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