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The spectrum of psychosis in multiple sclerosis: a clinical case series

Authors Gilberthorpe TG, O'Connell KE, Carolan A, Silber E, Brex PA, Sibtain NA, David AS

Received 8 July 2016

Accepted for publication 7 October 2016

Published 1 February 2017 Volume 2017:13 Pages 303—318

DOI https://doi.org/10.2147/NDT.S116772

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Thomas G Gilberthorpe,1 Kara E O’Connell,2,3 Alison Carolan,1 Eli Silber,4 Peter A Brex,4 Naomi A Sibtain,4 Anthony S David3

1Department of Liaison Psychiatry, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK; 2Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland; 3Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, 4Department of Neurology, Kings College Hospital, London, UK

Abstract: Psychosis in the context of multiple sclerosis (MS) has previously been reported as a rare occurrence. However, recent epidemiological studies have found prevalence rates of psychosis in MS that are two to three times higher than those in the general population. Untreated psychosis in patients with MS can adversely impact on adherence to MS medication, levels of disability, and quality of life. This retrospective case series describes the spectrum of psychotic disorders occurring in association with MS using demographic, clinical, and neuroimaging data. In the discussion, we highlight the particular diagnostic and treatment challenges that such disorders can pose for clinicians and through our case vignettes provide examples of potential interventions for this complex patient population.

Keywords: psychosis, multiple sclerosis, neuropsychiatric, cognitive, schizophrenia-like, demyelination

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