Cognitive and Psychiatric Status in Pediatric Multiple Sclerosis (MS) (P04.106)

Abstract

Objective: To assess the cognitive and psychiatric features of a sample of children with pediatric Multiple Sclerosis (MS). Background Children and adolescents with MS often have special needs as cognitive dysfunction and behavioral and emotional issues develop. The relation between cognitive, psychosocial, and psychiatric difficulties is poorly understood. Here, the goal was to examine the psychiatric, cognitive and neurologic features in pediatric MS. Design/Methods: Forty-five (45) pediatric onset MS patients (age range: 8.5 to 18.3, median: 15.7, female: 64.4%) underwent neurological evaluation, cognitive testing, and fatigue and quality of life (PedsQL) questionnaires. A child psychiatrist administered a semi-structured psychiatric interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and assessed global social and psychiatric functioning (CGAS). Cognitive impairment was defined as failing (i.e. 1 SD below published norms) 20% or more of 12 administered tests. Results: 27/45 (60%) of patients had at least one psychiatric disorder; 18/27 (66%) had more than one disorder. The most common diagnoses were anxiety disorder (n=12, 44.4%), depression (n=9, 33%), ADHD (n=9, 33%), adjustment disorder (n=4, 14.8%), PTSD (n=3, 11%), parent-child relationship problems (n=3, 11%) and ODD (n=2, 7%). There was one child each with bipolar disorder and reactive attachment disorder. Those with psychiatric diagnoses versus those without had slightly greater frequencies of cognitive impairment (74% vs. 55%, p =ns, particularly on tasks requiring complex attention, executive functioning and information processing speed), worse overall psychosocial functioning (lower CGAS scores, p Conclusions: Psychiatric disorders in children with pediatric MS are varied and are associated with increased fatigue, poor psychosocial functioning, and poor quality of life: Cognitive impairment is also frequent in this group. Disclosure: Dr. Weisbrot has nothing to disclose. Dr. Charvet has received personal compensation for activities with Johnson & Johnson as an employee. Dr. Serafin has nothing to disclose. Dr. Belman has nothing to disclose. Dr. Seibert has nothing to disclose. Dr. Moadel has nothing to disclose. Dr. Krupp has received personal compensation for activities with Teva Neuroscience, BiogenIdec, Serono, Inc., Bayer Pharmaceuticals Corporation, Guidepoint Global, Pfizer Inc, Axon Advisors, Sanofi-Aventis Pharmaceuticals, Inc., as a speaker, consultant and/or participant on an advisory board. Dr. Krupp has received (royalty or license fee or contractual rights) payments from Genzyme Corporation, Bristol-Myers Squibb Company, MedImmune, and Novartis. Dr. Krupp has received research support from Serono Inc. and Biogen Idec.