Premorbid Personality

Repeated attempts have been made, in retrospective investigations of patients already affected, to characterize a premorbid personality, and to determine characteristics of personality which dispose to the disease. Such investigations8 claimed that the premorbid personality of MS patients should be characterized by hysterical aspects, as notes on 'hysteria' are frequently found in case reports of MS patients. In fact, MS may manifest itself in earlier phases of the disease by various symptoms which may be found in hysterical ('histrionics') personalities: sensory disturbances, emotional instability, and particularly fatigue. If, from such observations, the inference is made that hysterical characteristics of personality may dispose to the development of MS, it only discloses a lack of ability to diagnose early manifestations of MS. 'In its infancy multiple sclerosis used to be called hysteria' said the famous Queen Square physician Farquhard Buzzard more than 100 years ago. Usually the term 'hysteria' is used imprecisely and includes conversion phenomena, dissociations, or only characteristics of individual personalities. Generally, it discloses more about the way in which physicians think about their patients than depending on clinically relevant data.9

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