Personality characteristics and disorders in multiple sclerosis patients: assessment and treatment.
ABSTRACT Multiple sclerosis (MS) is a major inflammatory and demyelinating disease of the central nervous system. Although a significant incidence and prevalence of psychological disorders in MS has been reported there is limited data on the prevalence of personality disorders (PD) in these patients. Recent findings indicate the need for early diagnosis and treatment of PD in MS patients in the interests of prognosis, conformity to treatment and patient's quality of life improvement. This article summarizes existing evidence on prevalence, types and diagnostic criteria of PD in MS, clinical manifestations of personality pathology or changes in MS patients, and instruments currently used for diagnosis and assessment of PD in this group of patients. Underlying mechanisms suggested as causes of personality changes in MS patients are also discussed. The article reviews therapeutic strategies, including pharmacotherapy and psychotherapy interventions and emphasizes the need for a multidisciplinary approach to patient's treatment.
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ABSTRACT: The origin and pathophysiological background of multiple sclerosis (MS)-associated fatigue is poorly understood. There is no unifying concept of its nature and its determinants to date. This paper reviews possible influences of factors determining personality profile on fatigue in MS. Likewise, the role of psychological factors and their interaction with personality to promote fatigue is discussed. Current data suggest that fatigue, especially in early MS states, may be influenced by vulnerable personality traits and personality-associated features. Among them are depressive disease coping, avoidance behavior and inhibition, irritability, less extraversion, neuroticism, lower reward responsiveness, and somatization behavior. However, among the validated personality factors, no genuine influences that are independent of depression have been documented. From a psychological perspective, depressiveness, anxiety, and somatization may be relevant mediators of fatigue. Interesting to note that in early MS, a psychiatric diagnosis is significantly more likely than on a later stage of the disease and that fatigue and motivation might share neural circuits. It is hypothesized that psychological factors promote fatigue in MS by psychological distress and sustained neuroendocrine and neurovegetative stress response. Despite the limitations of data discussed in the paper, personality research might help to disentangle specific promoting factors of fatigue in MS. Further research efforts are warranted since they might open ways to early psychological intervention of MS-associated fatigue. This is all the more important since medication is insufficient until now.Frontiers in Neurology 02/2015; 6. DOI:10.3389/fneur.2015.00002
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ABSTRACT: Few studies have investigated personality characteristics in people with multiple sclerosis (MS), and little is known about the relationship between personality and clinical characteristics in these patients. We aimed to investigate the personality traits of MS patients and their relationship with clinical characteristics. The study population consisted of 74 MS patients and age-matched, sex-matched, and education level-matched healthy controls. All participants were instructed to complete the self-administered 240-item Temperament and Character Inventory and the Beck Depression Inventory. The MS patients exhibited higher harm avoidance (HA) and lower self-directedness scores than the control group, although these differences disappeared after controlling for depression. Duration of the disease was positively correlated with HA and negatively correlated with novelty-seeking scores. Expanded Disability Status Scale scores were negatively correlated with reward dependence. Our results suggest a possible relationship between personality characteristics and the stage of the disease or the degree of damage in MS patients.The Journal of nervous and mental disease 04/2014; DOI:10.1097/NMD.0000000000000114 · 1.81 Impact Factor
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ABSTRACT: Multiple sclerosis is a chronic demyelinating disease affecting one million people worldwide, with a significant burden of psychiatric comorbidity. Depression is the commonest psychiatric manifestation but still remains largely underdiagnosed and undertreated. The present work reviews current knowledge on diagnosis, assessment, and somatic and psychotherapeutic treatment interventions for depression in adult and pediatric populations of patients with multiple sclerosis.01/2012; 2012:427102. DOI:10.5402/2012/427102