Qualification and predictors of the development of affective disorders in multiple sclerosi

Abstract

Affective disorders occupy one of the leading places in the structure of comorbidity in multiple sclerosis, but the questions concerning etiopathogenesis, qualification, diagnosis, and prediction of these disorders remain controversial. The most important consequences of affective disorders in MS include a decrease in the patient's quality of life, adherence to treatment, and their daily activities, and an increased risk of suicide and death from cardiovascular diseases. In this regard, the need for early detection and prediction of the development of depression in patients with MS is obvious. The following factors are considered among the predictors of the development of emotional distress and affective disorders: social, psychological, demographic, neurocognitive, and treatment-related factors, neuroimaging data, lifestyle features, comorbidities, characteristics of multiple sclerosis and its social implications. Specifically, younger age at the time of diagnosis, the presence of dyssomnia, fatigue, consumption of dairy products, atrophy of cortical areas in the frontal lobes, and decreased white matter volume of the uncinate fasciculus predict the development of depression. This article reviews the features of depressive and bipolar spectrum disorders in patients with MS.