David Freedman

Multiple Sclerosis Neuropsychiatry Fellow @UofTPsych / Psychiatry @UofTPsych / Medicine @MacDeptMed
Interested in neuropsych/mood disorders. All views my own.

[David Freedman @DavidEFreedman]

This study builds upon cross-sectional research that showed links between depressive symptoms and cognitive dysfunction (doi:10.1007/s00415-024-12409-x), and between cognitive impairment and decreased odds of having received CBT (doi:10.1016/j.msard.2026.107161).

[David Freedman @DavidEFreedman]

Recent RCT shows that CBT can improve depressive symptoms—and may even benefit cognition, anxiety, pain, sleep, QoL & illness acceptance—in people living with #MultipleSclerosis.

🔗 https://t.co/cFUJSx5B5O

[David Freedman @DavidEFreedman]

This is one of the first RCTs in #MS to demonstrate that addressing depression may lessen cognitive dysfunction.

[Jon Strum @RealTalkMS_jon]

https://t.co/j5j4J7x3bs Up to half of all people living with MS will experience clinical depression during their MS journey. We’re talking about it with Dr. Anthony Feinstein (@antfeinstein @UofT @uoftmedicine) on RealTalk MS. 🎧

#MultipleSclerosis #RealTalkMS #MSCommunity #MSAwareness #DepressionAwareness @MSCanOfficial

[CanPsychiatricAssoc @CPA_APC]

Psychiatry residents and fellows interested in research careers: apply for the CPA’s Junior Investigator Research Colloquium, held during the CPA Annual Conference (Montreal, Nov 18–21). The JIRC offers mentorship from leading researchers. Deadline: Mar 1 https://t.co/b69uhhX12K

[David Freedman @DavidEFreedman]

#MultipleSclerosis affects ~1 in 350 Canadians, and depression is more common in MS than in the general population. What should psychiatrists know about addressing depression in people with MS? @TheCJPsych @UofTPsych @Sunnybrook

https://t.co/icGNSQqG04

[Jonathan Rogers @drjprogers]

Neuropsychiatry is plagued by small sample sizes.

@ella_burchill is changing this with a BIG new paper on the relationship between psychosis and 15 neurological conditions in @BMJMentalHealth.

https://t.co/nLrrrF3Bx9

Here are some highlights...

[MSJ @MSJ_Research]

Affective reserve in #MultipleSclerosis: Definitions, measures, and potential benefits for people living with the disease, clinicians, and investigators.

Personal viewpoint from @Sunnybrook @UofT ▶️ https://t.co/mCqiAPylT0

[David Freedman @DavidEFreedman]

Why do some people with #MS avoid depression despite severe disease? A new paper introduces affective reserve—a buffer against biopsychosocial adversity, complementing cognitive & physical reserve. Hopeful, holistic, and ready for research. @UofTPsych

https://t.co/LeojeNpKsQ

[David Freedman @DavidEFreedman]

@RachelHorne19 @WomeninNeuroUK Congratulations!

[David Freedman @DavidEFreedman]

@UofTPsych @Sunnybrook

[David Freedman @DavidEFreedman]

How does the cognitive/mental health of people with #MultipleSclerosis change with aging? Our new study answers this question.

As people with #MS age, anxiety declines and cognition worsens, with no change in depression, fatigue, and cognitive concerns.

https://t.co/GEeF9X2Pab

[MSJ @MSJ_Research]

History of seizures independently predicts reduced cognition in people with #MultipleSclerosis, deserving further investigations on mechanisms and potential treatments.

Study from @DavidEFreedman @UofTPsych @Sunnybrook ▶️ https://t.co/nzq3v3wAPs

[David Freedman @DavidEFreedman]

@JD_Rosenblat @UofTPsych @IMSSAuoft @UofT @UofTNews @uoftmedicine @UHN @UHN_Research @KBI_UHN Well deserved, congratulations!

[David Freedman @DavidEFreedman]

Great work from Witt et al. on antidepressant use and associated pregnancy outcomes in people with #MultipleSclerosis

[MSJ @MSJ_Research]

Of 2,449 pregnancies in #MultipleSclerosis, 43.0% received symptomatic therapy (including antidepressants, analgetics and anticonvulsives), without adverse pregnancy outcomes or congenital abnormalities.

Study from @KerstinHellwig @ruhrunibochum @HHU_de
https://t.co/DpWTBnFdmE

[David Freedman @DavidEFreedman]

Interesting study showing a link between severe mental illness (e.g. bipolar disorder, psychosis) and delirium, highlighting the importance of thoughtful psychiatric consults for people admitted to medical units

[David Freedman @DavidEFreedman]

Fascinating work from Arora et al., highlighting the uncertainty about how to effectively treat psychosis in epilepsy. More research is needed!

[Jonathan Rogers @drjprogers]

Do antipsychotics work for psychoses in epilepsy?

You hear different things in clinical practice, so we wanted to do a systematic review of the literature.

Read the #OpenAccess article (https://t.co/WfhdhB9weo) or read on for a 🧵... (1/9)

[David Freedman @DavidEFreedman]

@CharleyBaker1 @RachelHorne19 @Suzannebritt60 @Helenlouiseford @ECTRIMS Such a great question, and we don't know the answer yet!

[David Freedman @DavidEFreedman]

Great overview of MS neuropsychiatry by @sanilrege!
While depression, anxiety, and cognitive dysfunction are more common in people with MS than in the general population, these conditions can be modifiable with effective neuropsychiatric care!

[Dr Sanil Rege FRANZCP | MRCPsych @sanilrege]

Behavioral Disorders in Multiple Sclerosis (MS) 🚨

Behavioral Changes in MS:

👉MS is associated with a broad range of behavioral symptoms, even in early disease stages.

Behavioural Domains / Disorders include :

👉Attention deficits
👉Anxiety, panic, and obsessive-compulsive disorders (OCD)
👉Irritability, agitation, and aggression
👉Oppositional and defiant behaviors
👉Disruptive emotional regulation and executive dysfunction
👉 behavioural changes are present in approximately 30-80% of individuals with MS.
👉often co-exist with depression and other neuropsychiatric disorders.

🚨Importantly, these symptoms are typically not correlated with motor deficits, suggesting separate pathophysiological mechanisms.

Neuroimaging Findings in MS: 🧠

Structural brain changes that correlate with behavioral symptoms:

👉Prefrontal cortical atrophy, which is linked to executive dysfunction and emotional regulation issues.

👉Disruptions in key brain networks, including the fronto-striato-thalamic and frontoparietal networks, which are associated with cognitive and behavioral control.

👉Evidence of interhemispheric inhibition, indicating impaired communication between brain hemispheres.

Paper 👉 https://t.co/F9Qaqh15wQ

Read more on Neuropsychiatry of Multiple Sclerosis - A Short Primer for Psychiatrists 👉 https://t.co/EdgHZ4fpLU

[Tom Fuchs @FuchsTom]

Just published! Cognition in people with multiple sclerosis can worsen silently in periods without relapse. Objective testing can help us capture and understand this change.

Thank you to @ECTRIMS for their support, to @imscogs for featuring this research in Bern Switzerland, and to all my colleagues that have contributed to this work.
@Mennoke @elisacolato @BiancaGuttman @AnatNeu_Ams @MScentrum020 @amsterdamumc
The Article: https://t.co/h9cFVNCoyC