Highlights
- •Psychiatric side effects are frequently reported in multiple sclerosis (MS) patients after high-dose corticosteroids (HDC).
- •We explored the HDC effect on mood and factors that influence mood changes in MS.
- •Our results indicated caution in HDC use for MS patients with bipolar symptoms.
- •An accurate screening for mood disorders is useful prior to pulse steroid therapy initiation.
Abstract
Background
Several reports suggest a higher risk of psychiatric disorders after high-dose corticosteroids
(HDC), routinely used to treat clinical relapses in multiple sclerosis (MS).
The present study aimed to examine the possible effect of HDC on mood in patients
with MS and to determine the specific factors that influence mood changes.
Methods
The study included MS patients prior to receive HDC. The presence of depressive and
bipolar symptoms was determined with the Beck Depression Inventory-Second Edition
(BDI-II) and the Mood Disorder Questionnaire (MDQ). These assessments were made at
three time points: prior to HDC initiation, after HDC completion, and 1 month after
HDC.
Results
The study included 101 MS patients. At baseline, 32 (31.7%) patients had depressive
symptoms (BDI-II scores ≥ 14) and 20 (19.8%) patients had bipolar symptoms (MDQ scores
≥ 7). While it was observed a reduction of BDI-II scores after HDC, an increase in
MDQ score was found in patients with MDQ positivity at baseline, resulting associated
with a higher number of HDC infusions (p 0.018).
Conclusions
Our results emphasize the importance of accurate screening for mood disorders in patients
with MS prior to HDC initiation, and indicate that HDC should be used with caution
in patients with MDQ positivity.
Keywords
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Article Info
Publication History
Published online: January 19, 2018
Accepted:
January 14,
2018
Received in revised form:
January 11,
2018
Received:
December 31,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
