The differential diagnosis of Axis I psychopathology presenting to a university-based multiple sclerosis clinic

Abstract

Patients carrying a presumptive diagnosis of multiple sclerosis (MS) sometimes present with non-specific clinical signs and symptoms that may be, at least in part, somatic manifestations of psychiatric conditions. This retrospective study was undertaken to identify psychiatric diagnoses among 63 patients whose initial clinical evaluations suggested a primary psychiatric, rather than a primary neurological, etiology for their symptoms. Some 92% of patients met Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) criteria for one or more primary psychiatric disorders, most often including somatoform, mood, and anxiety disorders. Accurate identification and diagnosis of psychiatric conditions producing pseudoneurological or non-specific somatic symptoms is necessary for both treatment and medico-economic reasons. Multiple Sclerosis 2007; 13: 749-753. http://msj.sagepub.com

Keywords

differential diagnosis multiple sclerosis psychophysiological disorders neurobehavioral manifestations somatoform disorders examinations

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References

Trojano M. , Paolicelli D. The diflflerential diagnosis ofl multiple sclerosis: classification and clinical fleatures ofl relapsing and progressive neurological syndromes . Neurol Sci 2001; 22 (Suppl 2): S98-102 .

Carmosino M. , Brousseau K. , Arciniegas D. , Corboy J. Initial evaluations flor multiple sclerosis in a university multiple sclerosis center . Arch Neurol 2005; 62: 585-90 .

Poser CM Misdiagnosis ofl multiple sclerosis and betainterfleron . Lancet 1997; 349: 1916 (Letter).

McDonald W. , Compston A. , Edan G. , Goodkin D. , Hartung HP , Lublin F. et al. Recommended diagnostic criteria flor multiple sclerosis: guidelines flrom the international panel on the diagnosis ofl multiple sclerosis . Ann Neurol 2001; 50: 121-27 .

American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, flourth edition - text revision. Washington, DC, American Psychiatric Association , 2000.

Crimlisk HL , Bhatia K. , Cope H. , David A. , Marsden CD , Ron MA Slater revisited: six year flollow up study ofl patients with medically unexplained motor symptoms . BMJ 1998; 316: 582-86 .

Mace CJ , Trimble MR Ten-year prognosis ofl conversion disorder . Br J Psychiatry 1996; 169: 282-88 .

Bass C. , Peveler R. , House A. Somatoflorm disorders: severe psychiatric illnesses neglected by psychiatrists . Br J Psychiatry 2001; 179: 11-14 .