title: Cognitive and psychiatric comorbidities in neuromyelitis optica.
abstract: OBJECTIVE
  Our primary objective was to examine the neuropsychological and psychopathological profile of patients with neuromyelitis optica (NMO) and compare these to multiple sclerosis (MS) and healthy control (HC) groups. We also examined for relationships between cognitive and psychiatric variables and clinical factors including accumulated neurological disability and disease duration.
  
  
  METHODS
  A neuropsychological test battery was administered along with a structured psychiatric interview and quantitative measures of mood symptoms.
  
  
  RESULTS
  42 NMO, 42 MS and 42 HC participants were assessed. Cognitive impairments were observed in 67% of NMO patients. The prevalence and profile of cognitive impairments and lifetime prevalence of depression was similar between NMO and MS groups. However, significantly higher rates of recurrent depression and suicidality were observed in NMO patients. Correlational analyses revealed higher levels of anxiety symptoms were associated with shorter disease duration in NMO, while higher depression symptom levels were associated with higher neurological disability and poorer cognition.
  
  
  CONCLUSIONS
  Our results demonstrate substantial cognitive and psychiatric comorbidities in NMO patients. Similar rates of lifetime and current depression between NMO and MS appear to mask greater underlying psychiatric burden in NMO and further understandings of the course of neurobehavioural comorbidities is required to better comprehend the additional morbidity in NMO. Our data support a role for cognitive and psychiatric assessments in the comprehensive care of NMO patients.
authors.affiliation: The Walton Centre NHS Foundation Trust, Liverpool, UK. Electronic address: perry.moore@thewaltoncentre.nhs.uk.
authors.forename: Perry
authors.initials: P
authors.lastname: Moore
authors.affiliation: University of Manchester, UK.
authors.forename: Abigail
authors.initials: A
authors.lastname: Methley
authors.affiliation: The Walton Centre NHS Foundation Trust, Liverpool, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Pollard
authors.affiliation: The Walton Centre NHS Foundation Trust, Liverpool, UK.
authors.forename: Kerry
authors.initials: K
authors.lastname: Mutch
authors.affiliation: The Walton Centre NHS Foundation Trust, Liverpool, UK.
authors.forename: Shahd
authors.initials: S
authors.lastname: Hamid
authors.affiliation: The Walton Centre NHS Foundation Trust, Liverpool, UK.
authors.forename: Liene
authors.initials: L
authors.lastname: Elsone
authors.affiliation: The Walton Centre NHS Foundation Trust, Liverpool, UK.
authors.forename: Anu
authors.initials: A
authors.lastname: Jacob
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000523:psychology; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000150:complications* / Q000523:psychology; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology; D009471:Neuromyelitis Optica / Q000150:complications* / Q000523:psychology; D009483:Neuropsychological Tests
keywords: Cognition; Comorbidities; Multiple sclerosis; Neuromyelitis optica; Psychopathology