Prevalence of depression in multiple sclerosis

Prevalência de depressão em portadores de esclerose múltipla

THESES

Prevalence of depression in multiple sclerosis (Abstract^*). Dissertation. Salvador, 2011

Ana Paula Torres Guedes Andrade^**

INTRODUCTION: The association between depression and multiple sclerosis (MS) is customary (about 37 to 60% of patients), with a suicide frequency 7.5 times higher than in healthy individuals. Many studies point to a common physiopathologic basis between these pathologies; there is evidence of neurologic lesions that disconnect some regions of cerebral cortex and/or subcortical pathways, like the fronto-temporal detachment caused by lesions on the arcuate fasciculus, or the hypothalamus-mediated endocrine dysfunction caused by inflammatory activity. The occurrence of this comorbidity in Brazilian population is yet underestimated. At Bahia, this datum does not exist. In addition, the drug treatment hasn't been effective.

OBJECTIVE: To estimate the prevalence of depression and the clinical and demographic profiles of patients with MS and to evaluate the applicability of Beck's Depression Inventory (BDI) among these persons.

METHOD: It has been performed an analytic descriptive transversal study. The diagnosis of MS has been performed using Poser's criteria; to depression, it has been used the BDI, and a psychiatric interview has ensued, using the Mini International Neuropsychiatric Interview (M.I.N.I.) for further analyses. Patients with suspect of Devic's disease, and demential syndrome have been excluded, along with patients with acute exacerbation of MS, those who are on interpheron, or have less than two years of diagnosis of MS.

RESULTS: 76 patients were included in this study. According to BDI criteria, 48.7% of the sample had depression, compared to 56%, following M.I.N.I. criteria. The concordance index between these two methods was almost perfect (kappa=0.84). 1 patient (1.4%) has suicided, and suicidal ideation was present in 21.3% of patients. The average age for presenting symptoms was 33.3 years, and the mean period of disease was 9.3 years. There was only a strong association between severe neurologic impairment and depression (p=0.05).

CONCLUSIONS: In accordance with current literature, depression among MS patients has higher prevalence than in other disabling neurologic diseases, corroborating with our datum of 48.7%. Although controversial, in our sample, depression correlated with a higher level of neurologic impairment and further disability. BDI may be an appropriate tool to evaluate depression in MS.

Key words: Multiple sclerosis, depression, Beck's Depression Inventory

*

Prevalência de depressão em portadores de esclerose múltipla (Resumo). Dissertação de Mestrado, Pós Graduação da Fundação Baiana para o Desenvolvimento das Ciências (Área: Neurociências). Orientador: Manuela Garcia Lima, Co-orientador: Antonio de Souza Andrade Filho.

Publication Dates

• Publication in this collection
  20 May 2011
• Date of issue
  2011