Multiple sclerosis and its psychiatric symptomatology – a case report

Abstract

Multiple sclerosis (MS) is a chronic disease with motor, cognitive, and other neuropsychiatric manifestations. Cognitive symptoms include impairments in attention, information processing efficiency and speed, executive functions, and long-term memory. Cognitive impairments are independent of the duration of the disease and are very little associated with neurological manifestations. Most MS patients need psychiatric treatment, usually for a cognitive or an affective disorder. Therapeutic management includes treatment of acute exacerbations, symptomatic treatment, and disease-modifying treatment/biological therapies. This case presentation aims to emphasize the need for interdisciplinary collaboration between psychiatrists and neurologists when facing the psychiatric manifestations of MS. Our patient is a 52-years old man who presented to our clinic with suicidal ideation with plan and method, depressive mood, multiple delusions, affective inversion towards family members, severe anxiety, and irritability, symptoms that led to significantly diminished functionality. He also presents neurological symptoms with severe damage to the motor area. MS is a chronic, progressive disease with well-known neurological symptoms. However, the psychiatric manifestations are often overlooked. MS is thought to be an autoimmune disorder in which the body’s immune system attacks the myelin sheath that protects nerve fibers, resulting in inflammation and damage, eventually leading to a loss of function. The psychiatric manifestations of MS can be just as debilitating as the physical symptoms and significantly reduce the quality of life. Therefore, an interdisciplinary approach between specialists in psychiatry and neurology is often needed to provide patients with the most appropriate medical care.