Behavioural symptoms and impairments in multiple sclerosis: a systematic review and meta-analysis.

Behavioural problems are not well recognized in multiple sclerosis (MS). In this review we aimed to evaluate the prevalence of behavioural symptoms and impairments in MS. A systematic search was carried out from MEDLINE, PsycINFO, Web of Science, CINAHL and COCHRANE. In total, 23 studies (1831 participants) were identified. Based on the literature search, behavioural symptoms and impairments are observed in MS. Aggression (23%), apathy (22%), euphoria (12%) and lack of insight (11%) were the most frequent symptoms, and adjustment disorder (17%) the most frequent impairment. Severe mental disorders are more infrequent than changes in behaviour, manner of reaction, and way of action. In conclusion the objective behavioural impairments and especially subjective symptoms are present in patients with MS. These manifestations should be taken into account in the diagnostics and treatment of the disease.