Commentary on 'Depression severity and its predictors among multiple sclerosis patients in Saudi Arabia: a cross-sectional study'

摘要

Multiple sclerosis (MS) is looked upon as chronic autoimmune disease.Current therapeutic research focus on the prevention of relapses in association with morphological magnet resonance imaging (MRI) parameters.This paper again describes that depression is one of the most common symptoms in MS.Components of depression for manifestation in MS are exogenous,such as disability,or endogenous,i.e.,due to localisation of lesions,which predispose for onset of depression.This paper points out that depression and related neuropsychiatric symptoms,i.e.,apathy and fatigue,should not be underestimated in the clinical maintenance of MS patients.This paper supports the view,that further research is warranted beyond past and future ongoing trials on cognitive deficits,which frequently disregard the impact of apathy and fatigur on standardised neuropsychological testing in association with chronic intake immune system modulating compounds.Therefore it is promising that efforts are undertaken on standardisation of neuropsychological assessment tools,i.e.for cognition,in trials[1],whereas the MiniMental State Examination score have a considerable bias by the educational level of the patient.Clinicians repeatedly point out,that non-cognition related signs are often essential limiting for quality of life.As a result,they investigate the efficacy of already available compounds often in observational or naturalistic small trials,like in this paper.Clinicians point out that non-cognition related signs are often essential limiting for quality of life.As a result,they investigate the efficacy of already available compounds often in observational or naturalistic small trials.These outcomes are frequently considered as less essential by the authorities driven evidence-based-medicine classification of trials.One must consider that most of the used assessment instruments are not objective.They are biased by the attitude and habits of the investigator.