DEPRESSION ASSOCIATED WITH MULTIPLE-SCLEROSIS - AN ETIOLOGIC CONUNDRUM

Objective: Although depression frequently occurs in multiple sclerosis (MS), an association with cerebral pathology is unclear. This sets MS apart from other common neurological disorders. The reasons for this are explored. Method: The literature on depression and magnetic resona nce imaging (MRT) is reviewed and methodological issues are critically evaluated. Results: Failure to demonstrate cerebral correlates of dep ression is in part a function of poor study design. However, the diffu se nature of cerebral demyelination creates difficulties in image anal ysis peculiar to MS. Conclusions: More research using valid psychiatri c assessment procedures, high field strength MRI and automated lesion detection is needed to resolve the issue. It is premature to reject ps ychosocial causes at this stage.