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How often is multiple sclerosis mistaken for a psychiatric disorder?

Published online by Cambridge University Press:  09 July 2009

K. Skegg ,
P. A. Corwin  and
D. C. G. Skegg
K. Skegg*
Affiliation:
Departments of Psychological Medicine and Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
P. A. Corwin
Affiliation:
Departments of Psychological Medicine and Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
D. C. G. Skegg
Affiliation:
Departments of Psychological Medicine and Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
*
1Address for correspondence: Dr Keren Skegg, Department of Psychological Medicine, University of Otago Medical School, Dunedin, New Zealand
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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.

Type
Brief Communication
Information
Psychological Medicine , Volume 18 , Issue 3 , August 1988 , pp. 733 - 736
Copyright
Copyright © Cambridge University Press 1988

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