Introduction Current estimates suggest the prevalence of multiple sclerosis (MS) may be approximately 600000 people in the United States. Although attention is typically focused on the physical disability associated with MS, the profound impact of mood disorders on the presentation and prognosis has recently begun to be appreciated.– Depression as an early and important clinical manifestation of MS is not a new observation, although it has taken over a century for systematic investigations to be undertaken. Recently, more efforts have been made by providers to treat depression as part of the comprehensive and holistic approach provided to patients with various general medical conditions. The prevalence and impact of comorbid depression in patients with MS cannot be ignored; notably, of all the mental state changes that could potentially occur with MS, depression is the most common by far. Independent of the premorbid prevalence of depression in patients diagnosed with MS, numerous reports have found that the incidence of depression after the onset of MS remarkably elevated four-fold. The profound impact that depression can have on a patient with MS necessitates its ascertainment and intervention. Epidemiology and impact of depression on MS From its earliest characterization, depression was among the first symptoms recognized as being associated with MS. Jean-Martin Charcot (1825–1893) was the first individual to provide an accurate and comprehensive clinicopathological description of MS, which he termed disseminated sclerosis. Charcot noted early on that grief, vexation, and adverse changes in social circumstance were related to the onset of MS. Even from its initial description, depression has been recognizable as a serious and potentially life-threatening component of MS.
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