Highlights
- •Neuromyelitis optica (NMO) is associated with substantial cognitive and psychiatric comorbities
- •Frequency of cognitive impairment in NMO is similar to multiple sclerosis (MS)
- •The lifetime course of psychiatric morbidity in NMO appears different to MS and may represent greater psychiatric burden
- •High rates of suicidality and recurrent depression in NMO highlight the need for clinical screening and appropriate treatments
Abstract
Objective
Our primary objective was to examine the neuropsychological and psychopathological
profile of patients with neuromyelitis optica (NMO) and compare these to multiple
sclerosis (MS) and healthy control (HC) groups. We also examined for relationships
between cognitive and psychiatric variables and clinical factors including accumulated
neurological disability and disease duration.
Methods
A neuropsychological test battery was administered along with a structured psychiatric
interview and quantitative measures of mood symptoms.
Results
42 NMO, 42 MS and 42 HC participants were assessed. Cognitive impairments were observed
in 67% of NMO patients. The prevalence and profile of cognitive impairments and lifetime
prevalence of depression was similar between NMO and MS groups. However, significantly
higher rates of recurrent depression and suicidality were observed in NMO patients.
Correlational analyses revealed higher levels of anxiety symptoms were associated
with shorter disease duration in NMO, while higher depression symptom levels were
associated with higher neurological disability and poorer cognition.
Conclusions
Our results demonstrate substantial cognitive and psychiatric comorbidities in NMO
patients. Similar rates of lifetime and current depression between NMO and MS appear
to mask greater underlying psychiatric burden in NMO and further understandings of
the course of neurobehavioural comorbidities is required to better comprehend the
additional morbidity in NMO. Our data support a role for cognitive and psychiatric
assessments in the comprehensive care of NMO patients.
Keywords
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Article info
Publication history
Published online: November 17, 2015
Accepted:
November 16,
2015
Received in revised form:
November 5,
2015
Received:
September 1,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.