Knud Jensen

Suicide and multiple sclerosis: an epidemiological investigation.

In a nationwide investigation the risk of death by suicide for patients with multiple sclerosis (MS) was assessed using records kept at the Danish Multiple Sclerosis Registry (DMSR) and the Danish National Register of Cause of Death. The investigation covers all MS patients registered with DSMR with an onset of the disease within the period 1953-85, or for whom MS was diagnosed in the same period. Fifty three of the 5525 cases in the onset cohort group committed suicide. Using the figures from the population death statistics by adjustment to number of subjects, duration of observation, sex, age, and calendar year at the start of observation, the expected number of suicides was calculated to be nearly 29. The cumulative lifetime risk of suicide from onset of MS, using an actuarial method of calculation, was 1.95%. The standard mortality ratio (SMR) of suicide in MS was 1.83. It was highest for males and for patients with onset of MS before the age of 30 years and those diagnosed before the age of 40. The SMR was highest within the first five years after diagnosis.

Attempted Suicide, Depression and Physical Diseases: A 1-Year Follow-Up Study

In the period January 1, 1990 to March 31, 1991 a sample of suicide attempters admitted to the Department of Psychiatry, Odense University Hospital, underwent a structured interview. In the study 52% of the patients interviewed were found to suffer from a somatic disease, and 21% were daily on analgesics for pain. Patients that suffered from a somatic disease differed from other suicide attempters in depression score, age, pain and the presence of psychosis. Fewer of the somatically ill suicide attempters had a psychosis. Patients complaining of pain were more often depressed and abused medicine. Statistically, the risk of repetition of parasuicide for patients with a somatic disease but without depression was significantly less. The 7 patients committing suicide were older and a tendency was found towards painful somatic diseases and depression as risk factors for suicide.

Effect of pregnancy on the prognosis for multiple sclerosis. A 5-year follow up investigation.

Introduction ‐ The purpose of the study was to evaluate the effect of pregnancy and childbirth on the longterm prognosis for women with multiple sclerosis (MS). Method and material ‐ A cohort of 39 women with definite MS were identified on 1.1.1986 using a reproducible selection method. The investigation was initiated in 1986 when handicap was evaluated by Kurtzke Disability Status Score (DSS). At a 5‐year follow up 4 had died and 6 could not participate. There were 29 women in the investigation of whom 7 were childless, 10 had onset of MS at least 6 months after last childbirth, and 12 had onset of MS before or in connection with childbirth. Age and disease duration of the group was uniform. Result ‐ At follow up the DSS significantly deteriorated (p = 0.008). The deterioration was seen particularly for childless women (p = 0.03) and women with onset of MS before or in connection with childbirth (p = 0.005).

Multiple sclerosis: correlation of psychiatric admissions to onset of initial symptoms

ABSTRACT— Forty‐two (12%) of a total of 366 patients with multiple sclerosis (MS) had psychiatric admissions. Of these, 34 (81%) had their first psychiatric admission in conjunction with or after the onset of MS. Classification by psychiatric diagnosis showed that there was a significant positive correlation between the onset of MS and the first psychiatric admission for psychoses and transient situational disorders, but not for neuroses.

Serum immunoglobulin M, G, and A concentration levels in Turner's syndrome compared with normal women and men

SummarySerum concentrations of immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA) were determined in 15 women with a lack of X chromosome material (Turners syndrome), and compared with the immunoglobulin concentrations in normal men and women. Further, the investigation is supplemented by a comparison of normal women and the Turner group matched according to age.The serum concentrations of IgG and IgA in women with Turners syndrome were very close to the concentration in serum from normal men, whereas the concentration of IgM was significantly lower. Compared to normal women the concentrations of IgG and IgM were significantly lower, and the concentration of IgA significantly higher in the Turner group.Whether these differences in serum immunoglobulins are determined by hormonal factors or under direct genetic control linked to the X chromosomes, is discussed.

Multiple Sclerosis: Sexual Dysfunctions

Multiple sclerosis (MS) is a disease that gives rise to sexual problems for the majority of affected patients. All former investigations involve patients with a variable mean disablement, and because of this, they are not comparable. Our investigation covers 117 patients, representatively chosen among all patients having MS, admitted to the Department of Neurology, Odense University Hospital in the period January 1, 1973–December 31, 1985 (Stenager et al., 1989a). The patients were asked whether they experienced changes in their sexual function after onset of disease. All patients had a neurological examination, and their physical disablement was evaluated using Kurtzkes Disability Status Scale (Kurtzke, 1983). The results were statistically evaluated, and the pattern of covariation was analyzed using a log-linear model for contingency table analysis. Sixty-five patients (55%) had experienced changes in their sexual function after onset of the disease. No statistically significant correlation between sex...

Multiple Sclerosis: The Impact of Physical Impairment and Cognitive Dysfunction on Social and Sparetime Activities

In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled suffered from severe psychosocial strain. The literature shows that the strain becomes even more severe in certain periods of progression of the disease with the result that psychosomatic conditions arise.

Sexual problems in multiple sclerosis.

Multiple sclerosis is a chronic disease of unknown etiology for which there is no causal treatment. For 2/3 of those inflicted, onset occurs between ages of 20-40 years and the men/women ratio is 2/3. The disease causes degeneration of the myelin in the white substance of the central nervous system, which can lead to a long row of symptoms including sexual problems. About 3/4 of the patients experience sexual disturbances (men 75%, women 75%). Men complain of erective dysfunction (2/3), reduced libido (1/3), insufficient orgasm (1/3), tiredness. Women complain of reduced sensibility in the genital region (1/2), insufficient orgasm (1/3), reduced libido, tiredness, vaginal dryness and dyspareunia. Both sexes may experience sexual difficulties due to muscle weakness, paralysis, spasticity, muscle cramps, urine incontinence, bladder catheter and partners lacking acceptance of a disabled sexual partner. Consequently almost half of these patients lose interest in sexual intercourse. It is important that therapeutic help is available in the form of sexual guidance and appropriate medication.

Multiple sclerosis: results of screening by the Token test in a representative sample.

Sir, Recent studies have demonstrated that cognitive deficits are frequent in multiple sclerosis (MS). The studies have concentra ted on subcort ical problems, while cortical problems have aroused little interest [4]. Speech disorders are well known in MS [1], but only a few studies are to be found on aphasia [2, 3]. In order to determine the frequency of mistakes in a screening test for aphasia, we have conducted a screening by a short form of the Token test in a representative sample of MS patients. Of 463 patients admitted to the Department of Neurology, Odense University Hospital, in the period April l th 1973 Dec. 31th 1985 with a diagnosis of MS, 285 fullfilled the following criteria: 1. definite MS according to the Poser criteria, 2. domicile in the county of Funen, 3. age span: 25-55 years, and 4. primary language Danish. Exclusion criteria were 1. other primary CNS disease, 2. other disease with secondary effects on the CNS, and 3. other chronic disease. Following random selection 160 patients remained. However, 39 did not wish to participate and 15 were unable to perform the test, leaving 106 patients, 48 males and 58 females, who entered the study. Of the 106 patients performing the Token test 17 (16%) made mistakes. About half (47%) made only one mistake, among whom were all the males. Four (24%) made 2 mistakes, 2 (12%) made 3 and 3 (18%) made more than 3 mistakes. Significantly more females than males made mistakes (Mantel-Haenzel; p=0.035) . Patients who made mistakes were characterized by higher mean age (Student t-test; p = 0.048), significantly longer mean duration of disease since both onset (ttest; p<0.0001) and diagnosis (t-test; p<0.0002), but no difference in the mean Beck Depression Inventory Score (Mann-Whitney; p=0 .31) compared to patients who did not make mistakes. The risk of making mistakes grew with increasing

Multiple sclerosis: symptom equivalent to delayed visual evoked potential latency

Abstract An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison to that of patients who mastered this task.