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Psychiatric morbidity in patients with clinically isolated lesions of the type seen in multiple sclerosis: a clinical and MRI study

Published online by Cambridge University Press:  09 July 2009

S. J. Logsdail
Affiliation:
The National Hospital for Nervous Diseases, London
M. M. Callanan
Affiliation:
The National Hospital for Nervous Diseases, London
M. A. Ron*
Affiliation:
The National Hospital for Nervous Diseases, London
*
1Address for correspondence Dr M.A. Ron, The National Hospital for Nervous Diseases, Queen Square, London WC1N 3BG.

Synopsis

This study reports the psychiatric morbidity in 76 patients with clinically isolated lesions of the type seen in multiple sclerosis (optic neuritis, brain stem and cord lesions). The presence or absence of brain pathology was investigated using magnetic resonance imaging (MRI). A group of 33 patients suffering from rheumatic and neurological conditions not known to involve the brain was used for comparison. Normative MRI data were obtained from a group of 40 normal volunteers.

Over half of the patients with the clinical presentation of single lesions had MRI abnormalities in the brain, but past and present psychiatric morbidity were similar in patients and controls and no significant associations were found between the presence of MRI abnormalities and psychiatric morbidity. The degree of social stress experienced by the patients with clinically isolated lesions appeared to be highly relevant in the causation of psychiatric symptoms.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1988

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References

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.CrossRefGoogle ScholarPubMed
Brant-Zawadski, M., Fein, C., Van Dyke, C., Kiernan, R., Davenport, L. & de Groot, J. (1985). MR imaging of the aging brain: patchy white matter lesions in dementia. American Journal of Neuroradiology 6, 675682.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1984). Psychiatric illness in patients with neurological disorders: patients' views on discussion of emotional problems with neurologists. British Medical Journal 289, 656658.CrossRefGoogle ScholarPubMed
Callanan, M. M., Logsdail, S. J., Ron, M. A. & Warrington, E. K. (1987). Cognitive impairment in patients with clinically isolated lesions of the type seen in multiple sclerosis. A psychometric and MRI study. (In preparation.)Google Scholar
Charcot, J. M. (1877). Lectures on the Diseases of the Nervous System. New Sydenham Society: London.Google Scholar
Cottrell, S. S. & Wilson, S. A. K. (1926). The affective symptomatology of disseminated sclerosis. Journal of Neurology and Psychopathology 7, 130.CrossRefGoogle ScholarPubMed
Dalos, N. P., Rabins, P. V., Brooks, B. R. & O'Donnell, P (1983). Disease activity and emotional state in multiple sclerosis. Annals of Neurology 13, 573577CrossRefGoogle Scholar
Davison, K. & Bagley, C R. (1969). Schizophrenia-like psychoses associated with organic disorders of the central nervous system: a review of the literature. In Current Problems in Neuropsychiatry (ed. Herrington, R. N.), pp. 113184. Headley: Ashford Kent.Google Scholar
Fog, T., Hyllested, K. & Andersen, S R. (1972). A case of benign multiple sclerosis with autopsy. Acta Neurologica Scandinavica Suppl 51, 369370.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). ‘Mini Mental State’. A practical method for grading the cognitive state of patients for the clinician Journal of Psychiatric Research 12, 189198.CrossRefGoogle ScholarPubMed
Francis, D. A., Compston, D. A S., Batchelor, J. R. & McDonald, W. I. (1987). A reassessment of the risk of multiple sclerosis developing in patients with optic neuritis after extended follow-up. Journal of Neurology, Neurosurgery and Psychiatry 50, 758765.CrossRefGoogle ScholarPubMed
Ghatak, N. R., Hirano, A., Lutmaer, H & Zimmerman, H. M. (1974). Asymptomatic demyelinated plaque in the spinal cord. Archives of Neurology 30, 484486.CrossRefGoogle ScholarPubMed
Gilbert, J. J. & Sadler, M. (1983). Unsuspected multiple sclerosis. Archives of Neurology 40, 533536.CrossRefGoogle ScholarPubMed
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Goldberg, D P. & Blackwell, B. (1970). Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal ii, 439443.CrossRefGoogle Scholar
Goldberg, D P.Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Prevenlative Social Medicine 24, 1823.Google ScholarPubMed
Horner, W. G., Hurwitz, T., Li, D. K. B., Palmer, M. & Paty, D. W. (1987). Temporal lobe involvement in multiple sclerosis patients with psychiatric disorders. Archives of Neurology 44, 187190.CrossRefGoogle Scholar
Jenkins, R., Mann, A. H. & Belsey, E. (1981). Design and use of a short interview to assess social stress and support in research and clinical settings. Social Science and Medicine 151, 195203.Google Scholar
Lyon-Caen, O., Jouvent, R., Hauser, S., Chau Nu, M. P., Benoit, N., Widlocher, D. & Lhermitte, F. (1986). Cognitive function in recent onset demyelinating diseases. Archives of Neurology 43, 11381141.CrossRefGoogle ScholarPubMed
McDonald, W. I. (1983). The significance of optic neuritis. Transactions of the Ophthalmological Society of the United Kingdom, 103, 230246.Google ScholarPubMed
McDonald, W. I. (1986). The pathophysiology of multiple sclerosis. In Multiple Sclerosis. (ed. McDonald, W. I. and Silberberg, D. H.), pp. 112133. Butterworths: London.Google ScholarPubMed
McDonald, W. I. & Silberberg, D. H. (1986). The diagnosis of multiple sclerosis. In Multiple Sclerosis (ed. McDonald, W. I. and Silberberg, D. H.), pp. 110. Butterworths: London.Google ScholarPubMed
Mann, A. H., Jenkins, R. & Belsey, E. (1981). The twelve month outcome of patients with neurotic illness in general practice. Psychological Medicine 11, 535550.CrossRefGoogle ScholarPubMed
Matthews, W. B. (1979). Multiple sclerosis presenting with acute remitting psychiatric symptoms. Journal of Neurology, Neurosurgery and Psychiatry 42, 859863.CrossRefGoogle ScholarPubMed
Norusis, M. J. (1986). SPSS/PC for the IBM PC/XT/AT. SPSS Chicago.Google Scholar
Ormerod, I. E. C., Miller, D H., McDonald, W. I., du Boulay, E. P. G. H., Rudge, P., Kendall, B. E., Moseley, I. F., Johnson, G., Tofts, P. S., Halliday, A. M., Bronstein, A. M., Scaravilli, F., Harding, A. E., Barnes, D. & Zilkha, K. J. (1988). The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions: A quantitative study. Brain (in the press).Google Scholar
Palacios, E., Fine, M. & Haughton, V M. (1980) Mulliplanar Anatomy of the Head and Neck for Computer Tomography. Wiley: New York.Google Scholar
Poser, C. M., Paty, D. W., Scheinberg, L., McDonald, W. I., Davis, S. A., Ebers, G. C. I., Johnson, K. P., Sibley, W. A., Silberberg, D. H. & Tourtelotte, W. W. (1983). New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Annals of Neurology 13, 227231.CrossRefGoogle ScholarPubMed
Rabins, P. V., Brooks, B. R., O'Donnell, P., Pearlson, G. D., Moberg, P., Jubelt, B., Coyle, P., Dalos, N & Folstein, M. F. (1986). Structural brain correlates of emotional disorder in multiple sclerosis. Brain 109, 585597.CrossRefGoogle ScholarPubMed
Schiffer, R. B. & Barbigian, H. M. (1984). Behavioural disorders in multiple sclerosis, temporal lobe epilepsy and amyotrophic lateral sclerosis. Archives of Neurology 41, 10671069.CrossRefGoogle ScholarPubMed
Schiffer, R. B., Caine, E. D., Bamford, K. A. & Levy, S. (1983). Depressive symptoms in patients with multiple sclerosis. American Journal of Psychiatry 140, 14981500.Google ScholarPubMed
Surridge, D. (1969). An investigation into some psychiatric aspects of multiple sclerosis. British Journal of Psychiatry 115, 749764.CrossRefGoogle ScholarPubMed
Whitlock, F. A. & Siskind, M. M. (1980). Depression as a major symptom of multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 43, 861865.CrossRefGoogle Scholar
Young, I. R., Hall, A. S., Pallis, C. A., Legg, N. J., Bydder, G. M. & Steiner, R. E. (1981). Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancett 11, 10631066.CrossRefGoogle Scholar