title: Psychiatric disturbances in radiologically isolated syndrome.
abstract: BACKGROUND
  Radiologically isolated syndrome (RIS) is characterized by incidental lesions suggestive of multiple sclerosis (MS) on MRI without typical symptoms of MS. Clinically isolated syndrome (CIS) is characterized by a first episode of neurologic symptoms caused by demyelination in the central nervous system. To date, psychiatric disorders have not been systematically addressed in RIS subjects. We assessed emotional disturbances, personality features and health-related quality of life (HRQoL) in a cohort of RIS patients as compared with clinically isolated syndrome (CIS).
  
  
  METHODS
  Twenty-eight RIS patients, 25 clinically isolated syndrome (CIS) patients, and 22 healthy subjects were enrolled in the study. Participants were administered a mood scale (Hamilton Depression Rating Scale), behavioural measures (Personality Assessment Inventory), and fatigue measures (Fatigue Impact Scale for Daily Use). HRQoL was quantified using the EuroQol-5.
  
  
  RESULTS
  14 (50%) of RIS patients had clinically significant depression, with over one-third of these having moderate depression, scores virtually identical to those observed in CIS patients. 11 of 28 (39.3%) subjects with RIS had anxious depression, a figure three times higher than that found in CIS patients. RIS patients' HAMD-17 total score showed a very strong correlation with severity of fatigue. In addition, RIS patients reported lower HRQoL (p = 0.036) and a significantly higher symptoms load for somatisation compared to both CIS and control groups (p < 0.002).
  
  
  CONCLUSIONS
  RIS patients had high rates of depression, particularly anxious depression and somatization. Future studies are warranted to clarify whether these psychiatric disturbances are causally associated with a distinct white matter psychopathologic process.
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Labiano-Fontcuberta
authors.affiliation: Department of Neurology, University Hospital of Getafe, Getafe, Madrid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Aladro
authors.affiliation: Department of Neurology, University Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Martínez-Ginés
authors.affiliation: Department of Neurology, University Hospital "Principe de Asturias", Alcalá de Henares, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Ayuso
authors.affiliation: Department of Psycho-oncology, Leicestershire Partnership Trust and University of Leicester, Leicester, UK.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Puertas
authors.affiliation: Department of Neurology, University Hospital of Getafe, Getafe, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Cerezo
authors.affiliation: Department of Neurology, University Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Higueras
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Complutense University, Madrid, Spain. Electronic address: jbenitol67@gmail.com.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology*; D015897:Comorbidity; D003711:Demyelinating Diseases / Q000453:epidemiology / Q000503:physiopathology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000503:physiopathology; D011788:Quality of Life; D013001:Somatoform Disorders / Q000453:epidemiology / Q000503:physiopathology*
keywords: Anxious depression; Clinically isolated syndrome; Depression; Health-related quality of life; Psychiatric; Radiologically isolated syndrome