**10. Conclusions**

There is conclusive data relating depression manifested clinically in a consequential manner in MS patients to a variety of unfavorable results in relation with occupations of daily living. Due to the particularly wide and varied implications of multiple sclerosis, it is important that the disciplinary team of physicians treating patients with this condition be alert to any changes in symptoms and aware of the increased prevalence of neuro-psychological disorders in the course of the disease.

This point is reinforced by studies showing the effectiveness of treatments for patients with multiple sclerosis and depression. Successful treatment will not only decrease MS-related morbidity; but it also has the potential to reduce suiciderelated mortality.

Related to the presence of associated symptoms, depression is the most common psychiatric complaint in patients with multiple sclerosis, and this conceives 25 to 50% of patients during the course of the disease, which is from two to five times higher compared to the prevalence rate in the general population. The cause of such a frequent occurrence of depression in patients with MS becomes more evident in the light of pathophysiology brain changes, and psychosocial changes are likely to be important in the course of the disease.

Psychiatric disorders have a significant frequency in multiple sclerosis cohort of patients. The risk of suicide is specifically considerable in the initially part of the disease's evolution. Anxiety is prevalent in multiple sclerosis and is the most influential prognosticator of the manifestation of depression. Major depressive disorder is inadequately diagnosed and treated. Behavioral impairments are more prevalent in comparison with severe psychiatric diseases and appear apparently subsequent to cognitive dysfunction. Addictions might be not diagnosed appropriately.
