What Do We Really Know About Cognitive Dysfunction,Affective Disorders,and Stress in Multiple Sclerosis? A Practitioner's Guide

Abstract

Multiple sclerosis (MS) patients often present with difficult neuropsychological and emotional problems. This article describes work undertaken by the psychology specialty panel in conjunction with a June 1993 Consortium of Multiple Sclerosis Centers (CMSC),sponsored conference entitled "What Do We Really Know About MS?" We summarize our critical review of one hundred seven controlled studies of cognitive dysfunction, affective disorders, and stress in MS, emphasizing what we know, what we believe we know, and what we do not know but need to know. We also present results of a survey of seventy-six MS practitioners (neurologists and mental health practitioners) covering beliefs about these topics and clinical practices, and we highlight discrepancies between our empirical knowledge and current clinical practices. Based on our literature review and practitioner survey, we identify critical gaps in our knowledge, highlighting the need for research on treatments for MS-related cognitive dysfunction, assessment of affective disturbance in MS, and effects of stress on disease activity.

Keywords

Cognitive dysfunction Affective disorders Stress Multiple sclerosis.

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