Affiliations: School of Psychology, Aristotle University of
Thessaloniki, Thessaloniki, Greece | 1st Department of Psychiatry, School of Medicine,
Aristotle University of Thessaloniki, Thessaloniki, Greece
Note: [] Corresponding author: Mary H. Kosmidis, Ph.D., School of
Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Tel.: +30 2310 997308; Fax: +30 2310 997384; E-mail: Kosmidis@psy.auth.gr
Abstract: Our purpose in undertaking the present study was to examine the
hypotheses proposed for explaining the frequent comorbidity of bipolar disorder
and multiple sclerosis. One hypothesis posits that, when there is comorbidity,
MS plays a causal role in psychiatric manifestations. Another suggests that
both disorders have a common underlying physiological process that increases
the likelihood of their co-occurrence. We examined two adult siblings with
comorbidity and their relatives, including three generations of family members
with psychiatric morbidity. We found an extensive multigenerational history of
bipolar disorder in this family. This history would seem to support the
hypothesis of a common underlying brain process (potentially genetically-based)
to explain the comorbidity of BD and MS, but cannot clarify whether this
comorbidity implies a relationship between the two disorders or merely reflects
parallel processes of brain deterioration. We cannot, however, rule out the
possibility of a subclinical MS-related process leading to the early
manifestation of BD, with MS appearing much later in time, or even a third,
undetermined factor, leading to familial comorbidity. Although we have
insufficient information to support either hypothesis definitively, we present
the familial cases as a springboard for a discussion of dilemmas related to
teasing apart MS and BD comorbidity. Further observation of the clinical course
of the younger family members, who have not yet shown any neurological signs,
over the next few years may elucidate the current picture further.
