How often is multiple sclerosis mistaken for a psychiatric disorder?
Abstract
Synopsis: In a defined population of 112000, an attempt was made to discover every patient with multiple sclerosis. Using strict diagnostic criteria, 91 patients were identified. A search of psychiatric records for the same population revealed that 15 (16%) of these patients were referred to psychiatrists between the onset of their symptoms and the diagnosis of multiple sclerosis. Ten (11 %) were seen with symptoms attributable to multiple sclerosis. These symptoms were recognized as neurological in only two cases, while the other eight patients received a variety of psychiatric diagnoses. Possible reasons for diagnostic error included the subjective nature of many early symptoms, histrionic behaviour, and psychiatric disturbance which drew attention away from physical symptoms. The results underline the caution needed when patients with physical symptoms are referred for psychiatric assessment.
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In a 1988 study, out of ten patients with MS initially seen by psychiatrists with symptoms attributable to MS, eight were diagnosed with a variety of psychiatric diagnoses.
“In a 1988 study, researchers identified all patients with a diagnosis of MS in prevalence assessments in 1976 and 1981 in a region of New Zealand, and found that out of ten who had initially been seen by psychiatrists with symptoms attributable to MS, eight were diagnosed with a variety of psychiatric diagnoses for symptoms such as weakness, balance incoordination, sensory symptoms, and vision los”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [13]
In that 1988 study, four (50%) of the eight were given a diagnosis of 'hysterical conversion' or similar.
“Four (50%) were given a diagnosis of “hysterical conversion” or similar.”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [13]
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Walzl, D., Solomon, A. J., & Stone, J. (2022) · Journal of Neurology · doi:10.1007/s00415-021-10436-6 · Cited by 62 · see citing works
- Authors
- Skegg, K., Corwin, P. A., & Skegg, D. C. G.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Skegg, K.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 1988-08
- Volume
- 18
- Issue
- 3
- Pages
- 733-736
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2111972014
- Cited by
- 59
- References
- 0
- Citations by year
- 2024: 2 · 2022: 1 · 2021: 3 · 2019: 1 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 4 · 2013: 2 · 2012: 3
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- multiple sclerosis, misdiagnosis, psychiatric referral, diagnostic errors, psychiatric comorbidity, early symptoms, neurological symptoms
- MeSH terms
- Adult, Mental Disorders, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Referral and Consultation, Neurocognitive Disorders
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