Differences in the burden of psychiatric comorbidity in MS vs the general population

Ruth Ann Marrie, John D Fisk, Helen Tremlett, Christina Wolfson, Sharon Warren, Aruni Tennakoon, Stella Leung, Scott B Patten, CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis, James Blanchard, Lawrence Elliott, Bo Nancy Yu, Virender Bhan, Joanne Profetto-McGrath, Larry Svenson, Nathalie Jette, Ruth Ann Marrie, John D Fisk, Helen Tremlett, Christina Wolfson, Sharon Warren, Aruni Tennakoon, Stella Leung, Scott B Patten, CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis, James Blanchard, Lawrence Elliott, Bo Nancy Yu, Virender Bhan, Joanne Profetto-McGrath, Larry Svenson, Nathalie Jette

Abstract

Objective: We aimed to compare the incidence and prevalence of psychiatric comorbidity in the multiple sclerosis (MS) population and in controls matched for age, sex, and geographic area.

Methods: Using population-based administrative health data from 4 Canadian provinces, we identified 2 cohorts: 44,452 persons with MS and 220,849 controls matched for age, sex, and geographic area. We applied validated case definitions to estimate the incidence and prevalence of depression, anxiety, bipolar disorder, and schizophrenia from 1995 to 2005. We pooled the results across provinces using meta-analyses.

Results: Of the MS cases, 31,757 (71.3%) were women with a mean (SD) age at the index date of 43.8 (13.7) years. In 2005, the annual incidence of depression per 100,000 persons with MS was 979 while the incidence of anxiety was 638, of bipolar disorder was 328, and of schizophrenia was 60. The incidence and prevalence estimates of all conditions were higher in the MS population than in the matched population. Although the incidence of depression was higher among women than men in both populations, the disparity in the incidence rates between the sexes was lower in the MS population (incidence rate ratio 1.26; 95% confidence interval: 1.07-1.49) than in the matched population (incidence rate ratio 1.50; 95% confidence interval: 1.21-1.86). Incidence rates were stable over time while prevalence increased slightly.

Conclusions: Psychiatric comorbidity is common in MS, and more frequently affected the MS population than a matched population, although the incidence was stable over time. Men with MS face a disproportionately greater relative burden of depression when they develop MS than women.

© 2015 American Academy of Neurology.

Figures

Figure 1. Forest plots of the association…
Figure 1. Forest plots of the association of the incidence of psychiatric comorbidity with study population (multiple sclerosis vs matched)
BC = British Columbia; CI = confidence interval; MB = Manitoba; NS = Nova Scotia; QC = Quebec.

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