J Neuropsychiatry Clin Neurosci 13:70-76, February 2001
© 2001 American Psychiatric Press, Inc.
Personality Disorder in Multiple Sclerosis Correlates With Cognitive Impairment
Ralph H.B. Benedict, Ph.D.,
Roger L. Priore, Sc.D.,
Colleen Miller, R.N., N.P., D.N.S.,
Frederick Munschauer, M.D. and
Lawrence Jacobs, M.D.
Received May 24, 1999; revised April 20, 2000; accepted May 9, 2000. From the Department of Neurology, State University of New York at Buffalo School of Medicine, Buffalo, New York. Address correspondence to Dr. Benedict, Department of Neurology, Buffalo General Hospital (D-6), 100 High Street, Buffalo, NY 14203.
Previous studies of personality change in multiple sclerosis (MS) relied on brief, nonstandardized assessments or tests that are confounded with symptoms of acute psychiatric disorder. Objectives of the present study were to evaluate character change in MS by using comprehensive trait measures of personality and to determine if there is an association between personality change and cognitive dysfunction. Thirty-four MS patients and 14 healthy volunteers were studied. All underwent comprehensive neurologic and neuropsychologic evaluation. Personality assessments included both self and informant reports on the Hogan Empathy Scale and the NEO Personality Inventory. Abnormalities were found among MS patients indicating elevated neuroticism and reduction in empathy, agreeableness, and conscientiousness. Large patient/informant discrepancies were observed in the MS but not the control group. Three neuropsychological tests emphasizing executive control predicted the presence of these abnormalities; this association suggests a neurogenic, frontal lobe syndrome.
Key Words: Multiple Sclerosis • Executive Dysfunction • Personality
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