In multiple sclerosis, cognitive disengagement syndrome (CDS) is associated with higher depression, insomnia, fatigue, and paresthesia

Dena Sadeghi-Bahmani; G Leornard Burns; Atefeh Meghrazi; Mohammad Hossein Abdollah; Annette B Brühl; Serge Brand; Stephen P Becker

doi:10.1177/20552173261417443

In multiple sclerosis, cognitive disengagement syndrome (CDS) is associated with higher depression, insomnia, fatigue, and paresthesia

Mult Scler J Exp Transl Clin. 2026 Feb 15;12(1):20552173261417443. doi: 10.1177/20552173261417443. eCollection 2026 Jan-Mar.

Authors

Dena Sadeghi-Bahmani^{1

2

3}, G Leornard Burns⁴, Atefeh Meghrazi⁵, Mohammad Hossein Abdollah⁵, Annette B Brühl³, Serge Brand^{3

6

7

8

9}, Stephen P Becker^{10

11}

Affiliations

¹ Department of Psychology, Stanford University, Stanford, CA, USA.
² The Wright Institute, Department of Clinical Psychology, Berkeley, CA, USA.
³ Center for Affective, Stress and Sleep Disorders, Psychiatric University of Basel, Basel, Switzerland.
⁴ Department of Psychology, Washington State University, Pullman, WA, USA.
⁵ Department of Psychology, Kharazmi University, Tehran, Iran.
⁶ Division of Sport Science and Psychosocial Health, Department of Sport, Exercise, and Health, Faculty of Medicine, University of Basel, Basel, Switzerland.
⁷ Health Institute, Substance Abuse Prevention Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
⁸ Sleep Disorders Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
⁹ Center for Disaster Psychiatry and Disaster Psychology; Center of Competence of Disaster Medicine of the Swiss Armed Forces, Basel, Switzerland.
¹⁰ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹¹ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Abstract

Background: Cognitive disengagement syndrome (CDS) refers to a set of attentional symptoms comprising daydreaming, mental fogginess, and hypoactivity clearly distinguishable from ADHD-IN and other forms of psychopathological issues.

Objective: The present study: (1) assessed CDS among adults with multiple sclerosis (MS) and healthy controls, and (2) investigated the associations between CDS and depression, insomnia, fatigue, and paresthesia in persons with MS.

Methods: Two-hundred and seven adults with MS (mean age: 36.64 years; 72.5% females) and 213 healthy controls (mean age: 34.19 years; 54.5% females) provided self-ratings of CDS, insomnia, depression, fatigue, and paresthesia.

Results: Compared to healthy controls, adults with MS reported higher scores for CDS (t(418 = 4.29, p < 0.001, d = 0.42), depressive symptoms (t(41) = 2.21, p = 0.014, d = 0.22), and insomnia (t(418) = 1.66, p = 0.049). Among the MS sample, higher levels of CDS were associated with higher depression (r = 0.64), insomnia (r = 0.34), fatigue (r = 0.53), and paresthesia (r = 0.28). Further, higher scores for depression, insomnia, and fatigue were independently associated with higher CDS.

Conclusions: Adults with MS experience greater CDS symptoms than healthy controls. Higher CDS scores were associated with depression, insomnia, fatigue, and paresthesia, which are typical of adults with MS. MS may contribute to or exacerbate CDS symptoms and be a potentially important target for further investigation.

Keywords: Multiple sclerosis; cognitive disengagement syndrome; depression; fatigue; insomnia; paresthesia; sluggish cognitive tempo.