A new comparison study of patients with autoimmune diseases reported high rates of anxiety and depression, with notable differences in when psychiatric symptoms emerged relative to disease onset.
A new cross-sectional comparison study showed that psychiatric comorbidities were frequent in patients with myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD), relapsing-remitting
Results from the study, presented at the
Presented by lead author Moritz Niederschweiberer, MD, neurologist at
In the study, investigators reviewed electronic medical records from patients prospectively enrolled between March 2020 and June 2025 at the Center for MS and Autoimmune Neurology at Mayo Clinic. The analysis included patients who met the 2023 diagnostic criteria for MOGAD, along with matched cohorts of patients with RRMS and aquaporin-4–IgG–positive NMOSD. Authors noted that the primary aim of the study was to assess the frequency and timing of psychiatric comorbidities across these demyelinating diseases.
In this NeurologyLive® Roundtable Discussion, neurologists Benjamin Greenberg, MD, and Jeffrey Bennett, MD, PhD, delved into the complexities of diagnosing and treating MOG antibody-associated disease (MOGAD). The duo share insight about the evolving diagnostic process and the current treatment landscape in MOGAD.
Overall, the study included 257 patients with MOGAD and 257 patients with RRMS, matched by sex and age at disease onset, as well as 58 patients with NMOSD. Median age at neurological onset was 35 years (interquartile range [IQR], 25–47) for both MOGAD and RRMS, compared with 47 years (IQR, 37–56) for NMOSD. Women participants comprised 63.9% of the MOGAD and RRMS patient cohorts and 89.7% of the NMOSD cohort. Investigators extracted data on current or past psychiatric disorders and, when available, the timing of psychiatric symptom onset relative to neurological disease onset. Pairwise comparisons were performed using Fisher’s exact test.
More than 5 years prior to neurological onset, investigators reported a significantly greater proportion of patients with RRMS who experienced the onset of depression or anxiety compared with patients with MOGAD (27.2% vs 17.6%; P= .037, respectively). In contrast, in the first year following neurological disease onset, psychiatric symptoms were significantly more likely to emerge among patients with MOGAD. In this early post-onset window, researchers noted that 23.1% of patients with MOGAD (n = 42) developed depression or anxiety, compared with 8.6% of individuals with RRMS (n = 14; P <.001).
Additional findings showed that attention-deficit/hyperactivity disorder occurred less frequently overall and did not differ significantly among the patient groups, affecting 8.9% of patients with MOGAD (n = 23), 10.1% with RRMS (n = 26; P = .65), and 5.2% with NMOSD (n = 3; P = .44). In addition, insomnia was relatively uncommon but occurred significantly more often in patients with NMOSD (n = 5, 8.6%) than in either individuals with MOGAD (n = 5; 1.9%; P = .009) or RRMS (n = 6; 6.6%; P = .019).
Authors noted that psychiatric comorbidities have been well described in MS and NMOSD research, and some prior studies have suggested that psychiatric symptoms may precede MS onset, raising the possibility of a presymptomatic phase.2 However, MOGAD is considered a more recently defined disease entity,3 and researchers noted there is limited data available regarding the psychiatric burden associated with this condition or how it compares temporally with other inflammatory demyelinating diseases of the central nervous system.4
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