Depression during multiple sclerosis relapse: relation to disability and relapse severity.

AIM: To examine the presence of depressive symptoms in patients with multiple sclerosis relapse and its relation to disability and relapse severity. METHODS: This study included 120 patients who were assessed during the acute relapse of multiple sclerosis according to Mc Donald criteria. Depression was assessed using Beck Depression Inventory II (BDI-II) calculating both affective and somatic symptom scores. The Expanded Disability Status Scale (EDSS) measured disability. Relapse severity was graded according to the difference between the EDSS score during relapse and EDSS score before the onset of the attack as mild, moderate or severe. RESULTS: There was statistically significant difference between patients with different level of depression considering age (p<0.001), disability (p<0.001), relapse severity (p=0.005) and disease duration (p=0.032). Significant moderate positive correlation of depression with age (rho=0.43) and disability (rho=0.46) was confirmed. There was moderate correlation between disability and somatic symptoms of depression (rho=0.54, p<0.001) with only weak correlation between disability and affective symptoms of depression (rho=0.31, p<0.01). Multiple regression analysis showed that patient's age and relapse severity (p<0.05) were independently related to depression in these patients while disability did not. CONCLUSION: Correlation between disability and depression was mostly due to somatic symptoms of depression. Although highly correlated, depression during multiple sclerosis relapse was not independently predicted by disability. Depression should be recognized and treated independently from disability treatment, especially in the group of older patients with more severe relapse.

[Evaluation of disease frequency in the first line relatives of patients suffering from schizophrenia related to gender and diagnostic categories].

INTRODUCTION: Schizophrenia represents the most severe mental disorder. The aim of this study was to determine the frequency of disease in the first line relatives of patients suffering from schizophrenia related to gender differences and various subtypes. MATERIAL AND METHODS: The study included 453 subjects (121 patients suffering from schizophrenia - 52.1% males and 47.9% females and 332 first line relatives of the patients - 47.2% males and 52.7% females during a five year period, mostly in the region of Sarajevo. RESULTS: According to the analysis of disease frequency related to the kinship, the disease developed more frequently in mothers (8.3%) and sisters (7.8%) than in fathers (6.9) and brothers (7.1%) of the patients suffering from paranoid schizophrenia. In the group of disorganized schizophrenia, only mothers were found (4.2%), whereas the statistical difference in the group of affected brothers and sisters was significant, the percentage being 9.7% and 15.3%, respectively. There was a statistically significant difference in gender (p < 0.05) between the group of parents and siblings regarding the frequency of schizophrenia. DISCUSSION: The proof of participation of genetic factors in etiology supports the assumption on genetic nature of familial aggregation of schizophrenia. Our results completely match those of studies which analyzed the frequency of disease regarding inheritance (gender distribution and various subtypes). CONCLUSION: Investigation points to the common epidemiological criteria regarding the frequency of schizophrenic psychosis. Genetic predisposition could be also a demonstrator of the disease course and outcome, which should enable better understanding of the etiology of this disease.