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ANXIETY AND DEPRESSION AS COMORBIDITIES OF MULTIPLE SCLEROSIS

Filip Mustač orcid id orcid.org/0000-0003-2851-6183 ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Hanna Pašić ; School of Medicine, Zagreb, University of Zagreb, Zagreb, Croatia
Filip Medić orcid id orcid.org/0000-0002-5658-6771 ; Ministy of Defence of the Republic of Croatia, Zagreb, Croatia
Borna Bjedov ; School of Medicine, Zagreb, University of Zagreb, Zagreb, Croati
Luka Vujević ; School of Medicine, Zagreb, University of Zagreb, Zagreb, Croati
Maša Alfirević ; Ministy of Defence of the Republic of Croatia, Zagreb, Croatia
Branka Vidrih ; Department of Psychiatry, University Hospital Centre Sisters of Mercy, Zagreb, Croatia ; Catholic University od Croatia, Zagreb, Croatia
Katarina Ivana Tudor ; School of Medicine, Zagreb, University of Zagreb, Zagreb, Croatia; Department of Neurology, Unit for Headaches, Neurogenic Pain and Spinal Disorders, University Hospital Centre Zagreb, Zagreb, Croatia
Marija Bošnjak Pašić ; Referral Center for Demyelinating Diseases of the Central Nervous System, Unit for Neuroimmunology of Central Nervous System, Clinical Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia ; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia


Puni tekst: engleski pdf 148 Kb

str. 480-485

preuzimanja: 224

citiraj


Sažetak

Multiple Sclerosis (MS), a chronic inflammatory neurodegenerative disease, is accompanied by a number of comorbidities.
Among the psychiatric ones, depression and anxiety occupy a special place. It is estimated that the prevalence of anxiety in the MS
population is 22.1% verus 13% in the general population; whereas the prevalence of anxiety levels, as determined by various
questionnaires, reaches even 34.2%. Systematic literature reviews (SPL) show considerable data variations due to differences in
study design, sample size, diagnostic criteria and extremely high heterogeneity (I2). Among the more conspicuous factors associated
with anxiety disorder in MS are demographic factors (age and gender), nonsomatic depressive symptoms, higher levels of disability,
immunotherapy treatments, MS type, and unemployment. Depression is the most common psychiatric commorbidity in MS and the
lifetime risk of developing depression in MS patients is >50%. According to some research, the prevalence of depression in MS vary
between 4.98% and 58.9%, with an average of 23.7% (I2=97.3%). Brain versus spinal cord lesions, as well as temporal lobe,
fasciculus arcuatus, superior frontal and superior parietal lobe lesions in addition to the cerebral atrophy have been shown to be the
anatomical predictors of depressive disorder in MS. Hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA) and the
consequent dexamethasone-insupressible hypercortisolemia, in addition to cytokine storm (IL-6, TNF-􀄮􀀏􀀃􀀷􀀪􀀩􀈕􀀔􀀏􀀃􀀬􀀩􀀱􀈖􀀒􀀬􀀯-4) present
the endocrine and inflammatory basis for development of depression. Fatigue, insomnia, cognitive dysfunction, spasticity,
neurogenic bladder, pain, and sexual dysfunction have shown to be additional precipitating factors in development of anxiety and
depression in MS patients.

Ključne riječi

multiple sclerosis; depression; anxiety; comorbidities

Hrčak ID:

271703

URI

https://hrcak.srce.hr/271703

Datum izdavanja:

19.10.2021.

Posjeta: 391 *