Disease of the neuromuscular junction, myasthenia gravis (MG) is manifested by excessive fatigability of the striated muscles on exertion. It often begins (almost half of cases) with isolated eye symptoms but ends, in 80 to 90% of cases, by affecting other muscles after a year (pharyngolaryngeal, limbs, respiratory, etc.).
A team of North American clinicians reviewed 32 studies (6,060 patients) published since 1971 on psychiatric comorbidities associated with MG. According to the results of this analysis:
- depression is 2 times less frequent in the general population than in patients with MG, which are almost a third to present depressive symptoms and this proportion increases with the duration of the disease, its severity and the existence of episodes respiratory failure;
- 46.3% of patients with myasthenia gravis suffer from an anxiety disorder (major anxiety, panic attack, etc.); this high prevalence could be related to the unpredictable and fluctuating nature of the disease, which increases the risk of developing over-planning behaviors, avoidance of others and anticipatory anxiety.
The authors emphasize the need to look for anxiety and depression in patients with autoimmune myasthenia gravis. They also detail the sometimes deleterious effects on the disease of certain psychoactive drugs (amitriptyline, diazepam, lithium, etc.) and, conversely, recall the possible psychiatric effects (insomnia, depression, anxiety, psychosis) of corticosteroid therapy very often. used to treat MG.
