Clinical assessment and therapy for depression

The occurrence of depression in multiple sclerosis (MS) patients is very high, with a lifetime prevalence of up to 50%. This co-occurrence has important negative consequences for MS patients. Until now, questions about the appropriateness of classification criteria and the reliability of assessment instruments have not been completely answered. At this time, it seems worthwhile to try to clarify these points considering their relevance for clinical and therapeutic approaches to treat MS and particularly to treat depression in MS. The risk of underestimating depressive symptoms is noted and appropriate treatment is strongly recommended. More recent antidepressant drugs are preferable in treating depression in MS patients because they have a better profile of side effects. At present, combined pharmacological and psychological therapy seems to be the best approach. Recently, rTMS was also proposed for treating depression in MS patients.[PUBLICATION ABSTRACT]