Screening for Comorbid Psychiatric Conditions in MS: Use of Validated Screening Tools

Doctor with x ray
Doctor with x ray
Barriers to using screening tools included lack of time and lack of insurance compensation.
The following article is part of live conference coverage from the 2018 ACTRIMS Forum in San Diego, California. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from ACTRIMS 2018.

Validated screening tools are not regularly employed to screen patients with multiple sclerosis (MS) for comorbid cognitive impairment or depression, according to research presented at ACTRIMS 2018, held February 1-3 in San Diego, California.

Researchers reviewed electronic medical records (EMRs) of 300 patients with MS who attended 2 large specialty clinics in the United States. Surveys were administered to 11 leaders in MS treatment and research at 10 US academic medical centers.

EMR documentation suggested that validated tools were rarely used to assess cognitive impairment and depression (2% and 3%, respectively), although these conditions are common in people with MS (36% and 44%, respectively), according to informal assessment. Screening rates were “similar across the 2 MS clinics,” according to investigators. Only 64% of patients with documented depression were referred to a psychiatrist, and only 26% of patients with documented cognitive impairment were referred to a neuropsychologist.

When survey respondents reported not using validated tools, they cited lack of time to administer and analyze results, lack of supporting evidence, lack of insurance compensation, and personal preference for assessing cognition and mood through “loosely structured patient interviews” as primary reasons.

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“Given the high prevalence of cognitive impairment and depression among [patients with MS] and the negative impact of these comorbidities on quality of life, these findings have implications for addressing variations in the uptake of international recommendations to screen patients for cognitive impairment and clinical depression,” researchers concluded.

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Buckle GJ, Robertson D, Moreo N, Aungst A, Carter J, Sapir T. Screening for cognitive impairment and depression in MS patients: current practices, perceptions, and barriers in selected United States MS clinics. Presented at: ACTRIMS Forum 2018. February 1-3, 2018; San Diego, CA. Abstract P161.