Are your patients with depression also experiencing PBA?
Pseudobulbar affect (PBA) is commonly comorbid with depression or other mood and behavioral disorders. Screen for PBA when patients with neurologic conditions or brain injury are diagnosed with and treated for depression but are still experiencing involuntary, sudden, frequent laughing and/or crying episodes.1-4
57.5% OF PATIENTS
In a clinical study, more than half of patients who were diagnosed with PBA had comorbid depression (N=367).5,a,b
70.8% of patients in the study were taking psychopharmacologic medications.
aPRISM II was a 90-day, open-label, single-arm, 74-site, US trial in adult patients with dementia, stroke, or TBI. All patients received a clinical diagnosis of PBA by their physician and had a Center for Neurologic Study-Lability Scale (CNS-LS) score ≥13 at baseline. CNS-LS is a 7-item self-report rating scale that measures perceived frequency and control over laughing and/or crying episodes. It was validated as a PBA screening tool in ALS and MS populations. CNS-LS ≥13 may suggest PBA but does not confer a PBA diagnosis.4-8
bBased on Patient Health Questionnaire-9 (PHQ-9), a 9-item assessment of depressive symptoms. Scores range from 0 to 27, with higher scores indicating increased depression severity.5
Differentiate PBA from depression by recognizing the characteristics of crying9
- Matches how the patient feels
- Mostly controllable; stops when mood changes
- Onset and duration defined by mood
- Disproportionate to or inconsistent with how the patient feels
- Happens frequently, suddenly, and may be brief
These are not all the diagnostic features of depression.7 Formal diagnosis of depression or PBA can only be made by a qualified healthcare practitioner.
Various mood and behavioral disorders can affect patients with neurologic conditions or brain injury2
Depression is only one of many behavioral disorders that have symptoms similar to PBA. Crying or other outbursts are common among these disorders as well, which can complicate the diagnosis of PBA.1,3,4,9-11