Background: Radiologically Isolated Syndrome (RIS) represents a pre clinical stage of Multiple Sclerosis (MS) in 30–33 % of cases. Depression in MS is reported in 50 % or more of patients, exacerbates the course of the disease, increases suicide risk, and impairs quality of life. 

Objective: To investigate risk factors for depression in patients with MS that developed following RIS.

Materials and Methods: The main group included 35 patients with RIS that converted to MS and depression. RIS was characterised by asymptomatic demyelinating brain lesions on MRI. MS diagnosis was established by a neurologist according to the McDonald criteria (2010, 2017), and depression diagnosis was made by a psychiatrist in accordance with ICD 10. A radiologist reviewed the brain MRI findings. Depression was mild in 34.29 % and moderate in 65.71 % of cases. The comparison group comprised 35 MS patients without depression and without a history of RIS, matched for sex and age. The following scales were applied: Beck Depression Inventory (BDI), Spielberger State Trait Anxiety Inventory (STAI), Multidimensional Fatigue Inventory (MFI 20), Paced Auditory Serial Addition Test, Expanded Disability Status Scale. The mean age at examination onset was 28.2 (2.5) years. The age at RIS to MS conversion was 34.7 (2.9) years on average, and the mean duration of MS was 5.23 (2.51) years.

Results: A statistically significant strong association was found between depression in patients with MS and a history of RIS, in conjunction with the following factors: Female sex, lower educational attainment, social maladjustment, asthenia (90.5 ± 1.1 points on the MFI 20 scale), anxiety as measured by the STAI (trait anxiety: 48.53 ± 0.39 points, state anxiety: 45.18 ± 0.85 points), multiple brain lesions on MRI (20 or more, predominantly in the frontal and temporal regions of the right cerebral hemisphere), and cognitive impairments. This issue has not been previously investigated.

Conclusion: The study results facilitate the identification of a high risk group of patients with multiple sclerosis and antecedent radiologically isolated syndrome. This enables targeted early screening for depression by a multidisciplinary team and delivery of personalised specialised care, leading to improved clinical outcomes.

Ksenia Gubskaia, psychiatrist, candidate of medical sciences (Specialty: Psychiatry), currently pursuing a doctorate in medical sciences, associate professor at the department of psychiatry, narcology, and psychotherapy at the Ivanovo State Medical University. She successfully integrates clinical practice with research and teaching activities. She has been a member of the Russian Committee of Multiple Sclerosis Researchers since 2011. Her primary research focus is on psychiatric disorders associated with multiple sclerosis. She holds a patent for a computer program designed to predict the risk of depression development in patients with MS. She is an active and regular participant in international scientific conferences and congresses, where she presents her research findings.