Beyond physical disability: the case for systematic mental health screening in the care of NMOSD and MOGAD in Latin America.

Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are rare demyelinating diseases whose clinical follow-up has traditionally centered on physical disability, measured through scales such as the EDSS, relapse frequency, and visual acuity. However, recent evidence from the region shows a considerable psychological burden (anxiety and depression) in these patients, along with elevated risks of suicidality and unemployment. Despite this, no Latin American clinical management consensus for NMOSD or MOGAD incorporates systematic mental health screening as part of standard follow-up. This article argues that such screening using brief, validated, low-cost tools such as the PHQ-9 and GAD-7 should be integrated as a routine component of care for these patients in the region, rather than remaining an isolated research finding.