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Stress, Depression and Antidepressant Treatment Options in Patients Suffering from Multiple Sclerosis

Citation

Schumann, R and Adamaszek, M and Sommer, N and Kirkby, KC, Stress, Depression and Antidepressant Treatment Options in Patients Suffering from Multiple Sclerosis, Current Pharmaceutical Design, 18, (36) pp. 5837 - 5845. ISSN 1381-6128 (2012) [Refereed Article]

Copyright Statement

Copyright 2012 Bentham Science Publishers

DOI: doi:10.2174/138161212803523671

Abstract

Stress constitutes a risk factor for diseases where the immune system plays a significant role. Stress is recognized as a possible trigger for flare ups during the course of multiple sclerosis (MS). The disclosure to the patient of the diagnosis of MS, the commencement of immunomodulatory therapy, and the unpredictability and vagaries of disease progression are all sources of stress. Biological stress systems such as the hypothalamic-pituitary-adrenal system and the sympathetic nervous system may influence the pathogenesis and the disease course of MS. The ability to cope with stress may also be impaired, mediated for example by cognitive deficits or loss of abilities and resources as disease progresses or by the high prevalence of concurrent mood disturbances such as depression and chronic fatigue. Psychiatric comorbidities of MS disease or therapy as well as impairments of coping strategies are underrecognized in clinical practice. Treatment plans for depression among MS patients, as the most common psychiatric comorbidity, should be individualized with integrated approaches. Antidepressants are effective for the treatment of depression in MS patients although further clinical research into the neurobiological and psychological bases of depressive disorders in MS patients is clearly needed. In therapy, coping strategies can be enhanced through multidisciplinary assessment of the various challenges and restrictions imposed by the disease and assisting and supporting the patient in addressing these. Exercise, as a form of positive stress (eustress), also has a role in therapy.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Psychiatry (incl. Psychotherapy)
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Mental Health
Author:Kirkby, KC (Professor Kenneth Kirkby)
ID Code:82539
Year Published:2012
Web of Science® Times Cited:11
Deposited By:Medicine (Discipline)
Deposited On:2013-02-06
Last Modified:2013-08-26
Downloads:0

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