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. 2016 Jun 29;6(9):e00493.
doi: 10.1002/brb3.493. eCollection 2016 Sep.

Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

Ruth Ann Marrie  1 , Scott B Patten  2 , Jamie Greenfield  3 , Lawrence W Svenson  4 , Nathalie Jette  5 , Helen Tremlett  6 , Christina Wolfson  7 , Sharon Warren  8 , Joanne Profetto-McGrath  9 , John D Fisk  10 ; CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis; James Blanchard  11 , Patricia Caetano  11 , Lawrence Elliott  11 , Bo Nancy Yu  11 , Virender Bhan  11 , Larry Svenson  11
Affiliations

Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

Ruth Ann Marrie et al. Brain Behav. .

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.

Keywords: administrative data; anxiety; comorbidity; depression; multiple sclerosis.

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Figures

Figure 1
Figure 1
Annual incidence per 100,000 persons of psychiatric comorbidity in the MS and matched populations in 1999.
See this image and copyright information in PMC

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