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Letters   |    
Psychiatric Symptoms Accompanying Multiple Sclerosis Onset: A Case Report
Elias Andreoulakis, M.D., M.Sc., Ph.D.; Ioannis Nimatoudis, M.D., Ph.D.; Ioanna Ierodiakonou-Benou, M.D., Ph.D.; Apostolos Iacovides, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E06-E09. doi:10.1176/appi.neuropsych.13030055
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3rd Psychiatric Department, School of Medicine, Aristotle University of Thessaloniki, Greece

Correspondence: Dr. Andreoulakis; e-mail: andreli@med.auth.gr

Copyright © 2014 by the American Psychiatric Association

Extract

To the Editor: Psychiatric symptoms have been reported, although rarely, among the presenting symptoms of multiple sclerosis (MS). The case presented here refers to a 46-year-old man with no previous psychiatric history, who, immediately after MS diagnosis, manifested delusional ideas of jealousy, illustrating the collaboration of psychosocial and biological factors—with the former probably representing a trigger—in the development of a mental disorder on the grounds of organic brain disease. Of note, the patient’s symptoms had remained refractory to treatment with second-generation antipsychotics alone and remitted only after a combination of both first- and second-generation antipsychotics was applied.

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FIGURE 1. Brain MRI: Multiple Hyperintensities Suggesting MS, Cerebellar and Left Temporal Atrophy

FIGURE 2. Cervical Spine MRI: MS Lesion at the Level of C5 and C6
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