What Are the Clinical Features of People with Both Obsessive-Compulsive Disorders and Multiple Sclerosis?

What you need to know

• Obsessive-compulsive disorders (OCDs) occur more frequently in people with multiple sclerosis (MS) than in the general population, but the reasons for this are not well understood.
• This protocol describes a planned scoping review to map existing knowledge about the clinical characteristics of people who have both OCD and MS.
• The review aims to summarize what is known about the prevalence, potential causes, clinical course, and treatment considerations for this group of patients.

Understanding Multiple Sclerosis and Obsessive-Compulsive Disorders

Multiple sclerosis (MS) is a condition that affects the central nervous system, including the brain and spinal cord. In MS, the immune system mistakenly attacks the protective covering of nerve fibers, called myelin. This damage disrupts communication between the brain and the rest of the body, leading to a variety of symptoms.

Common symptoms of MS include:

• Vision problems
• Muscle weakness
• Numbness or tingling sensations
• Difficulty with balance and coordination
• Fatigue
• Cognitive changes

MS affects about 2.8 million people worldwide. It can significantly impact a person’s quality of life and ability to work.

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by:

1. Obsessions: Unwanted, intrusive thoughts, images, or urges that cause anxiety or distress.
2. Compulsions: Repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession.

For example, someone with OCD might have intrusive thoughts about contamination (obsession) and feel compelled to wash their hands excessively (compulsion) to relieve their anxiety.

OCD and related disorders affect approximately 1.3% of the global population. These conditions can be very distressing and interfere with daily life.

The Connection Between MS and OCD

Research has found that OCD occurs more frequently in people with MS than in the general population. While about 1.3% of people overall have OCD, studies suggest that around 8.6% of people with MS experience OCD. This means that OCD is over 6 times more common in people with MS.

Scientists don’t fully understand why OCD is more prevalent in people with MS, but there are several possible explanations:

1. Shared biological mechanisms: Both MS and OCD may involve similar processes in the brain or immune system.

2. Psychological factors: The stress of living with MS could potentially trigger or worsen OCD symptoms in some people.

3. Medication effects: Some treatments for MS might influence brain chemistry in ways that could increase the risk of OCD.

4. Detection bias: People with MS may have more frequent contact with healthcare providers, potentially leading to higher rates of OCD diagnosis.

Why This Review is Important

Despite the higher occurrence of OCD in people with MS, there has been little research specifically focused on individuals who have both conditions. Understanding more about this group of patients is important for several reasons:

1. Improved patient care: By understanding the unique challenges faced by people with both MS and OCD, healthcare providers can offer more tailored and effective treatments.

2. Research directions: Identifying gaps in current knowledge can guide future studies to answer important questions about the relationship between MS and OCD.

3. Potential insights into disease mechanisms: Studying the overlap between MS and OCD might provide clues about the underlying causes of both conditions.

What This Review Will Do

The researchers have designed a scoping review to gather and summarize all available information about people who have both MS and OCD. A scoping review is a type of study that aims to map out what is known about a topic, identify gaps in knowledge, and suggest areas for further research.

The review will look at several key areas:

1. Epidemiology: How common is it for people to have both MS and OCD? Are certain groups more likely to have both conditions?

2. Clinical course: How do MS and OCD symptoms develop and change over time in people who have both conditions? Does having one condition affect the progression of the other?

3. Potential causes: Are there shared genetic, environmental, or other risk factors that might explain why some people develop both MS and OCD?

4. Management considerations: What are the best approaches for treating people who have both MS and OCD? Are there special considerations for medication use or therapy?

The researchers will search multiple databases of scientific literature to find relevant studies. They will also look for information in conference presentations, dissertations, and other sources. By casting a wide net, they hope to capture as much relevant information as possible.

How the Review Will Be Conducted

The research team has developed a detailed plan for carrying out the review:

1. Defining the question: The main question guiding the review is “What is known about the clinical dimensions of people with co-occurring obsessive-compulsive and related disorders and multiple sclerosis?”

2. Searching for information: The team will use a carefully designed search strategy to find relevant articles and other sources of information.

3. Selecting studies: Two independent reviewers will screen the search results to decide which articles should be included in the review.

4. Extracting data: The researchers will use a standardized form to collect important information from each included study.

5. Summarizing the findings: The team will use descriptive statistics and narrative summaries to present what they learn from the review.

Throughout the process, the researchers will consult with people who have MS to ensure that the review addresses questions that are important to patients.

Potential Limitations

The researchers acknowledge some potential limitations of their planned review:

1. Language restriction: The review will only include articles available in English, which could miss relevant information published in other languages.

2. Quality assessment: Due to the nature of a scoping review, the researchers won’t formally evaluate the quality of the included studies.

3. Evolving classifications: OCD and related disorders have been classified differently over time, which could affect how the researchers identify relevant studies.

Conclusions

• This scoping review will provide a comprehensive overview of what is currently known about people who have both MS and OCD.
• The findings could help healthcare providers better understand and care for patients with both conditions.
• By identifying gaps in current knowledge, the review will highlight important areas for future research on the relationship between MS and OCD.

This review represents an important step in improving our understanding of how MS and OCD interact. The results could lead to better care for people living with both conditions and open new avenues for research into the underlying mechanisms of these complex disorders.