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Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

View Article: PubMed Central - PubMed

ABSTRACT

Background: Risk factors for psychiatric comorbidity in multiple sclerosis (MS) are poorly understood.

Objective: We evaluated the association between physical comorbidity and incident depression, anxiety disorder, and bipolar disorder in a MS population relative to a matched general population cohort.

Methods: Using population‐based administrative data from Alberta, Canada we identified 9624 persons with MS, and 41,194 matches. Using validated case definitions, we estimated the incidence of depression, anxiety disorder, and bipolar disorder, and their association with physical comorbidities using Cox regression, adjusting for age, sex, socioeconomic status, and index year.

Results: In both populations, men had a lower risk of depression and anxiety disorders than women, as did individuals who were ≥45 years versus <45 years at the index date. The risk of bipolar disorder declined with increasing age. The risks of incident depression (HR 1.92; 1.82–2.04), anxiety disorders (HR 1.52; 1.42–1.63), and bipolar disorder (HR 2.67; 2.29–3.11) were higher in the MS population than the matched population. These associations persisted essentially unchanged after adjustment for covariates including physical comorbidities. Multiple physical comorbidities were associated with psychiatric disorders in both populations.

Conclusion: Persons with MS are at increased risk of psychiatric comorbidity generally, and some physical comorbidities are associated with additional risk.

No MeSH data available.


Annual incidence per 100,000 persons of psychiatric comorbidity in the MS and matched populations in 1999.
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brb3493-fig-0001: Annual incidence per 100,000 persons of psychiatric comorbidity in the MS and matched populations in 1999.

Mentions: We identified 9624 MS cases and 41,194 matched controls (Table 1). In 1999, the crude annual incidence of depression, anxiety disorders, and bipolar disorder were higher in the MS population than in the matched population (Fig. 1). These associations were consistent for 1999–2011 (Fig. S1‐S3). Tables S1 and S2 show age‐specific and sex‐specific average annual incidence rates of depression, anxiety disorders, and bipolar disorder. The incidence of depression and anxiety disorders were higher among women than men in both populations, but the incidence of bipolar disorder did not differ by sex.


Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis
Annual incidence per 100,000 persons of psychiatric comorbidity in the MS and matched populations in 1999.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5036426&req=5

brb3493-fig-0001: Annual incidence per 100,000 persons of psychiatric comorbidity in the MS and matched populations in 1999.
Mentions: We identified 9624 MS cases and 41,194 matched controls (Table 1). In 1999, the crude annual incidence of depression, anxiety disorders, and bipolar disorder were higher in the MS population than in the matched population (Fig. 1). These associations were consistent for 1999–2011 (Fig. S1‐S3). Tables S1 and S2 show age‐specific and sex‐specific average annual incidence rates of depression, anxiety disorders, and bipolar disorder. The incidence of depression and anxiety disorders were higher among women than men in both populations, but the incidence of bipolar disorder did not differ by sex.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Risk factors for psychiatric comorbidity in multiple sclerosis (MS) are poorly understood.

Objective: We evaluated the association between physical comorbidity and incident depression, anxiety disorder, and bipolar disorder in a MS population relative to a matched general population cohort.

Methods: Using population‐based administrative data from Alberta, Canada we identified 9624 persons with MS, and 41,194 matches. Using validated case definitions, we estimated the incidence of depression, anxiety disorder, and bipolar disorder, and their association with physical comorbidities using Cox regression, adjusting for age, sex, socioeconomic status, and index year.

Results: In both populations, men had a lower risk of depression and anxiety disorders than women, as did individuals who were ≥45 years versus <45 years at the index date. The risk of bipolar disorder declined with increasing age. The risks of incident depression (HR 1.92; 1.82–2.04), anxiety disorders (HR 1.52; 1.42–1.63), and bipolar disorder (HR 2.67; 2.29–3.11) were higher in the MS population than the matched population. These associations persisted essentially unchanged after adjustment for covariates including physical comorbidities. Multiple physical comorbidities were associated with psychiatric disorders in both populations.

Conclusion: Persons with MS are at increased risk of psychiatric comorbidity generally, and some physical comorbidities are associated with additional risk.

No MeSH data available.