Research Article| Volume 42, 102128, July 2020

Evaluation of types of psychological disorders in patients with neuromyelitis optica spectrum disorder (NMOSD)


      • The present study investigates psychological aspects of patients with NMOSD compared to healthy individuals.
      • Patients with NMOSD significantly suffered from psychological disorders compared to healthy controls.
      • These disorders should be thoroughly examined to offer more effective therapies in this regard.



      Neuromyelitis Optica Spectrum Disorder (NMOSD), commonly characterized by affecting optic nerves and spinal cord can be regarded as one of uncommon diseases of the central nervous system. Although the evidence presented in the literature supports cognitive impairments, psychological aspects of the disease and its association with various manifestations of the disease have not been thoroughly studied. Therefore, the present study was conducted to investigate psychological aspects of patients with NMOSD compared to healthy individuals.

      Materials and Methods

      The patients’ demographic information including their age and gender as well as the information about their disease including duration of the symptoms, the age at onset of symptoms, and NMO antibody status were collected using a specific questionnaire. Then, age- and gender-matched control participants that neither themselves nor their relatives had mentioned disease were included in the study. Then, Symptom Checklist-90 (SCL-90) test was administered to both groups.


      A total of 36 patients including 32 females and 4 males participated in the NMOSD group. In the control group, 37 healthy individuals including 30 females and 7 males took part in the study. Findings of the present study indicated that, patients with NMOSD significantly suffered from psychological disorders such as depression, anxiety, hostility, and somatization compared to healthy controls. The phobic anxiety and psychoticism showed trends toward being worse. However, obsessive compulsive symptoms, interpersonal sensitivity and paranoid ideation did not have significant differences between the two groups.


      According to results of the present study, as psychological disorders are common among patients with NMOSD, they should be thoroughly examined to offer more effective therapies in this regard. In addition, the psychological manifestations of NMOSD may influence patients’ relationship, occupation and treatment compliance. So, evaluation of these factors is important in these patients.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Multiple Sclerosis and Related Disorders
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. He, D., et al., Cognitive function, depression, fatigue, and activities of daily living in patients with neuromyelitis optica after acute relapse. 2011a. 121(12): p. 677–683.

        • He D.
        • et al.
        Cognitive impairment and whole brain diffusion in patients with neuromyelitis optica after acute relapse.
        Brain Cogn. 2011; 77: 80-88
        • Kim H.J.
        • Paul F.
        • Lana-Peixoto M.A.
        MRI characteristics of neuromyelitis optica spectrum disorder: an international update.
        Neurology. 2015; 84: 1165-1173
        • Wingerchuk D.M.
        • Banwell B.
        • Bennett J.L.
        • et al.
        International consensus diagnostic criteria for neuromyelitis optica spectrum disorders.
        Neurology. 2015; 85: 177-189
        • Vanotti S.
        • Cores E.V.
        • Eizaguirre B.
        • et al.
        Cognitive performance of neuromyelitis optica patients: comparison with multiple sclerosis.
        Arquivos Neuro Psiquiatr. 2013; 71: 357-361
        • Mealy M.A.
        • et al.
        Epidemiology of neuromyelitis optica in the United States: a multicenter analysis.Arch.
        Neurol. 2012; 69: 1176-1180
        • Moore P.
        • et al.
        Cognitive and psychiatric comorbidities in neuromyelitis optica.
        J Neurol Sci. 2016; 360: 4-9
        • Oertel F.C.
        • Schließeit J.
        • Brandt A.U.
        • et al.
        Cognitive impairment in neuromyelitis optica spectrum disorders: a review of clinical and neuroradiological features.
        Front. Neurol. 2019; 10: 608
        • Salama S.
        • Marouf H.
        • Reda M.I.
        • Mansour A.R.
        • ELKholy O.
        • Levy M
        Cognitive functions in Egyptian neuromyelitis optica spectrum disorder.
        Clin. Neurol. Neurosurg. 2019 Nov 25; 189105621
        • Shin J.S.
        • Kwon Y.N.
        • Choi Y.
        • Lee J.Y.
        • Lee Y.I.
        • Hwang J.H.
        • Choi S.H.
        • Kim S.M
        Comparison of psychiatric disturbances in patients with multiple sclerosis and neuromyelitis optica.
        Medicine (Baltimore). 2019 Sep; 98: e17184
        • Chavarro V.S.
        • et al.
        Insufficient treatment of severe depression in neuromyelitis optica spectrum disorder.
        Neurol Neuroimmunol Neuroinflamm. 2016; 3: e286
        • Cotter J.
        • Trew F.
        • Colville S.
        • Lyle D.
        • Cranley D.
        • Cormack F.
        • Barnett J.H.
        • Murray K.
        • Pal S
        Screening for cognitive impairment among patients with neuromyelitis optica using touchscreen cognitive testing in routine clinical care.
        J. Neurol. 2019 Oct; 266: 2571-2572
      2. Jean V.M., Paul R.H., Beatty W.J., Psychological and neuropsychological predictors of coping patterns by patients with multiple sclerosis. 1999. 55(1):21–26.

        • Vallejo M.A.
        • Jordan C.M.
        • Diaz M.I.
        • et al.
        Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R).
        J. Med. Internet Res. 2007; 9 (e2): 1
        • Liu Y.
        • Tang X
        Depressive Syndromes in Autoimmune Disorders of the Nervous System: prevalence, Etiology, and Influence.
        Front Psychiatry. 2018 Sep 25; 9: 451
        • Pan J.
        • Zhao P.
        • Cai H.
        • et al.
        Hypoxemia, sleep disturbances, and depression correlated with fatigue in neuromyelitis opticaspectrum disorder.
        CNS Neurosci. Ther. 2015; 21: 599-606A
        • Akaishi T.
        • et al.
        Depressive state and chronic fatigue in multiple sclerosis and neuromyelitis optica.
        J Neuroimmunol. 2015; 283: 70-73
        • Shi Z.
        • et al.
        Factors that impact health-related quality of life in neuromyelitis optica spectrum disorder: anxiety, disability, fatigue and depression.
        J Neuroimmunol. 2016; 293: 54-58