Table 9.

Included references

Author, year	Symptom or disorder category	MS population	Diagnostic assessment tools	Main findings	Comments
Duncan et al. 2016 [48]a	Euphoria	n = 100 Age: 44.5 ± 11.2 Female (n): 86 South Africa	using the classical and contemporary measure and definition of euphoria	The MS group demonstrated high frequencies of euphoria using the classical measure but low frequencies using the contemporary measure and definition. The matched control group demonstrated significantly higher rates than the MS group using the classical measure and lower rates than the MS group using the contemporary measure. The discrepancies in incidence rates of euphoria noted in the literature do not reflect a change in the incidence of euphoria in MS, but rather in the definition and operationalization of “euphoria”	Furthermore, these results highlight the importance of characterizing what represents pathological euphoria as well as the need for better definitions and instruments of measure
Hanna et al. 2016 [51]a	Pseudobulbar affect	n = 153 Age: 45.6 ± 8.1 Female (n): 119 Canada	MACFIMS, CNS-LS, HADS	MS subjects positive for pathological laughing and crying on the CNS-LS but without depression had lower scores on the controlled oral word association test, a measure of verbal fluency, and the California verbal learning test—2 immediate recall score, a verbal memory measure. This study demonstrates a connection between cognitive impairment, specifically verbal fluency and verbal learning, and pathological laughing and crying in MS subjects	Further studies are warranted to explore the causative relationship between cognitive impairment and pathological laughing and crying
Hasselmann et al. 2016 [31]a	Depression	n = 139 Age: 43.7 ± 10.7 Female (n): 101 Germany	BDI-II, ICD-10	Comparisons on a whole-group level produced the expected differences along somatic/non- somatic symptoms. However, when appropriately controlling for depression severity, age, and sex, only four items contributed differentially to BDI-II total scores in MS versus MDD. Depression construct is essentially identical in both groups. The clinical phenotype of “idiopathic” MDD and MS-associated depression appears similar when adequately examined	The relevance of psychotherapeutic approaches for MS- associated depression should be explored in future studies
Hind et al. 2016 [66]b	Depression	NA	CES-D (-10), BDI-I/-II, BDI-FS, CMDI, DSM, HADS, mBDI, MeSH, PHQ-9, PROMIS-D-8, YSQ	Twenty-one studies (N = 5,991 Patients with MS) evaluating 12 instruments were included in the review. Risk of bias varied greatly between instrument and validity domain. Well-conducted evaluations of some instruments are unavailable for some validity domains. This systematic review provides an evidence base for trade-offs in the selection of an instrument for assessing self-reported symptoms of depression in research or clinical practice involving people with MS	Detailed and specific recommendations for where further research is needed
Hoang et al. 2016 [38]a	Anxiety	n = 5084 Age: NA Female (n): NA Denmark	ICD-10	MS patients have increased risk of depression and anxiety in both the pre- and the post-diagnostic period and the use of TCAs and SSRIs is higher than in the control population	None
Litster et al. 2016 [76]b	Anxiety	NA	HADS-A, BAI, GAD-7, DSM-IV, SCAN	The criterion validity of three screening tools was assessed: the Hospital Anxiety and Depression Scale–Anxiety (HADS-A), Beck Anxiety Inventory (BAI), and 7-item Generalized Anxiety Disorder Scale (GAD-7). The HADS-A was validated against the Structured Clinical Interview for DSM-IV, the Sched- ules for Clinical Assessment in Neuropsychiatry (SCAN) interview, and the BAI. The BAI was validated against the SCAN, and the GAD-7 was validated against the HADS-A. The HADS-A had higher measures of sensitivity and specificity than did the BAI and the GAD-7	Based on this small sample, the HADS-A shows promise as an applicable measure for people with MS. Screening scales used to identify anxiety in MS must be validated against appropriate reference standards

The selected studies are sorted chronologically by year and alphabetically by author name. Types of articles: ^aEmpirical article; ^bReview article; Definition papers were not included in the table. n = sample size; age: mean ± standard deviation; NA = Not applicable/reported

Abbreviations: BAI Beck Anxiety Inventory, BDI–FS Beck Depression Inventory–Fast Screen, BDI (-I/-II) Beck Depression Inventory, CES-D (-10) Center for Epidemiologic Studies Depression Scale (10-item scale, identical to the CES-D), CMDI Chicago Multiscale Depression Inventory, CNS-LS Center for Neurologic Study Emotional Lability Scale, DSM(-III/-IV) Diagnostic and Statistical Manual of Mental Disorders, GAD-7 7-item Generalized Anxiety Disorder Scale, HADS (-A/-D) Hospital Anxiety and Depression Scale (-Anxiety Scale/-Depression Scale), ICD-9/-10 International Classification of Disease, mBDI Modified Beck Depression Inventory, MACFIMS Minimal Assessment of Cognitive Function in MS, MDD Major Depressive Disorder, MeSH Medical Subject Headings, MS Multiple Sclerosis, PHQ-2/-9 Patient Health Questionnaire, PROMIS-D-8 Patient Reported Outcome Measurement Information System Depression 8-item bank, QoL quality of life, SCAN Structured Clinical Interview, YSQ Yale Single Question