Psychiatric problems are more common in MSers


Background:Psychiatric comorbidity is common among multiple sclerosis (MS) patients. The majority of MS patients of working ages are on disability pension. The aims of this study were to chart the prevalences of psychiatric diagnoses and medications among MS patients of working ages, and to investigate their association with the risk for future disability pension.
Methods:This nationwide, population-based prospective cohort study includes 10,750 MS patients and 5,553,141 non-MS individuals who in 2005 were aged 17–64 years. Psychiatric diagnoses and medications were identified using nationwide registers. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated adjusting for socio-demographics. Furthermore, a survival analysis with five-year follow-up was performed among the 4,571 MS patients not on disability pension in 2005, with psychiatric diagnoses and medication as risk factors, and disability pension as the outcome.
Results:Among MS patients, 35% had been prescribed psychiatric medication compared to 10% of non-MS individuals, adjusted OR 3.72 (95% CI 3.57 to 3.88). Ten percent of MS patients had received a psychiatric diagnosis, compared to 5.7% of non-MS individuals, OR 1.82 (95% CI 1.71 to 1.94). Serotonin reuptake inhibitors (SSRIs), were the most commonly prescribed drugs (17%) among MS patients, while depression (4.8%) was the most common psychiatric diagnosis. MS patients with any psychiatric diagnosis had a hazard ratio (HR) of 1.83 (95% CI 1.53 to 2.18) for disability pension compared to other MS patients. MS patients with any psychiatric drug prescription had a HR for disability pension of 2.09 (95% CI 1.84 to 2.33).
Conclusion Psychiatric diagnoses and medications are common among MS patients and adversely affect risk for disability pension. This highlights the importance of correct diagnosis and management of psychiatric comorbidity, in a clinical as well as in a societal perspective.

This study highlights what has been said previously that MS can be associated with cognitive problems this report says the Hazard ratio is about 2 in many tests. The hazard ratio (HR) is the ratio of the hazard rates corresponding to the conditions described by two levels of an explanatory variable. For example, in this study, people with MS had twice the rate of psychiatric problems per unit time as the control population, non-MS population. The hazard ratio would be 2, indicating higher hazard of pyschoactive problems. Psychiatric diagnoses and medications are common among MS patients and adversely affect risk for disability pension. 

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  • From the tables it looks like it is mostly depression/anxiety/bipolar that are more common. ( well, it would be strange if people did not get depressed or anxious when they are faced with a diagnosis like that and the prospect of progressing disability). Cognitive problems are another story, but are maybe more the domain of neuropsychologists.
    But knowing what MRIs in MS look like – isn't it amazing that there isn't more work for the psychiatrists here?

  • Can reading the vast array of research and proposed disease mechanisms in MS cause psychiatric problems?

    • Most definitely……I use to think I was a man in a white coat now I'm a furry animal sometimes in need need of a straight jacketl:-)

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