Features of depressive disorders and suicidal behavior in multiple sclerosis

Objective. The aim of the literature review was to analyze the epidemiological features, pathogenetic relationships and pathomorphological changes that determine the high incidence of depressive disorders in the population of patients with multiple sclerosis. Material and methods. The analysis of the literature presented in the aggregator databases was carried out: PubMed, Google Scholar, CyberLeninka, eLIBRARY. The review includes the results of studies, meta-analyses, systematic reviews of scientific literature. For the search, queries were formed with the following keywords: «depression», «suicide», «multiple sclerosis», «quality of life». Results. It was found that the high prevalence of depressive disorders in patients with multiple sclerosis is due to the commonality of individual links in the pathogenesis of these pathological conditions. In multiple sclerosis, as well as in depressive disorders, there is stigmatization, misunderstanding from others, colleagues and relatives. Pathogenetic aspects of comorbidity are caused by disruption of the serotonergic and dopaminergic systems of the brain, neuroinflammatory processes, and vitamin D deficiency. The presence of multiple sclerosis creates the preconditions for the development of symptoms of depression, which, in turn, cause an increase in the severity and rate of its progression, trapping the patient in a vicious circle in which both diseases mutually reinforce each other. Conclusion. Raising awareness of depressive disorders in MS, individualized treatment approaches, and improving the quality of social, psychological, and pharmacological care for individuals suffering from this serious illness will help develop an effective care system for this category of patients.