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Descriptive Epidemiology of Affective Disorders in Multiple Sclerosis

Published online by Cambridge University Press:  07 November 2014

Abstract

Background: Affective disorders present an important clinical challenge in multiple sclerosis (MS). Due to prohibitive sample size requirements, population-based studies have not yet provided an adequate description of the underlying epidemiology of this association.

Objective: To describe the epidemiology of affective disorders in MS in a general population sample.

Methods: The study presented here accessed administrative data from a universal healthcare insurance plan in the Canadian province of Alberta. Physician billing data recorded in the Alberta Health Care Insurance Plan was used to identify members of the population ≥15 years of age with and without MS. Crude and stratified estimates of the association between affective disorders and MS were made. Logistic regression analysis was used to evaluate statistical interactions and to provide adjusted estimates of the association.

Results: The estimated prevalence of MS in the population within the targeted age range (2.3 million individuals) was 386/100,000 and that of affective disorders was 7.7%. As expected, an association between MS and affective disorders was identified (crude relative prevalence: 2.2). The association varied in strength over age-sex categories. Although the prevalence of affective disorder was higher in women with MS than men with MS, the association of MS with affective disorders was stronger in men. The strength of association declined with age in both men and women. Affective disorder prevalence in people with MS becomes similar to that of the general population in older age groups.

Conclusion: Affective disorders occur with an increased frequency in MS. This is true in men and women and across all relevant age groups, although the association gets weaker with advancing age. Higher frequencies of affective disorder occur in women with MS than in men with MS. The frequency of affective disorder in people with MS is highest in the 25–44 age group, and declines in older age categories.

Type
Original Research
Copyright
Copyright © Cambridge University Press 2005

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References

1.Schiffer, RB, Caine, ED, Bamford, KA, Levy, S. Depressive episodes in patients with multiple sclerosis. Am J Psychiatry. 1983;140:14981500.Google ScholarPubMed
2.Minden, SL, Orav, J, Reich, P. Depression in multiple sclerosis. Gen Hosp Psychiatry. 1987;9:426434.Google Scholar
3.Sadovnick, AD, Remick, RA, Allen, J, et al. Depression and multiple sclerosis. Neurology, 1996;46:628632.Google Scholar
4.Patten, SB, Metz, LM, Reimer, MA. Biopsychosocial correlates of major depression in a multiple sclerosis population. Mult Scler. 2000;6:115120.CrossRefGoogle Scholar
5.Joffe, RT, Lippert, GP, Gray, TA, Sawa, G, Horvath, Z. Mood disorders and multiple sclerosis. Arch Neurol. 1987;44:376378.CrossRefGoogle ScholarPubMed
6.Patten, SB, Beck, CA, Williams, JVA, Barbui, C, Metz, L. Major depression in multiple sclerosis: a population-based perspective. Neurology. 2003;61:15241527.CrossRefGoogle ScholarPubMed
7.Benito-León, J, Morales, JM, Rivera-Navarro, J. Health-related quality of life and its relationship to cogntive and emotional functioning in multiple sclerosis patients. Eur J Pharmacol. 2002;9:497502.Google Scholar
8.Wang, JL, Reimer, MA, Metz, LM, Patten, SB. Major depression and quality of life in individuals with multiple sclerosis. Int J Psychiatr Med. 2000;30:309317.CrossRefGoogle ScholarPubMed
9.Feinstein, A. An examination of suicidal intent in patients with multiple sclerosis. Neurology. 2002;59:674678.CrossRefGoogle ScholarPubMed
10.Mohr, DC, Goodkin, DE, Likosky, W, Gatto, N, Baumann, KA, Rudick, RA. Treatment of depression improves adherence to interferon beta-lb therapy for multiple sclerosis. Arch Neural. 1997;54:531533.CrossRefGoogle Scholar
11.Mohr, DC, Goodkin, DE, Islar, J, Hauser, SL, Genain, CP. Treatment of depression is associated with suppression of nonspecific and antigen-specific T-H1 responses in multiple sclerosis. Arch Neurol. 2001;58:10811086.Google Scholar
12.Karaffa, MC. International Classification of Diseases. 9th ed. 4th rev. clinical modification. Los Angeles, Calif: Practice Management Information Corp.; 1992.Google Scholar
13.Svenson, LW, Woodhead, SE, Platt, GH. Regional variations in the prevalence rates of multiple sclerosis in the province of Alberta, Canada. Neuroepidemiol. 1994;13:813.Google Scholar
14.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
15. Statistics Canada Web site. Available at: http://www.statcan.ca. Accessed on June 30, 2004.Google Scholar
16.Stata. College Station, Tex: Stata Corporation; 2001.Google Scholar
17.SAS/STAT User's Guide. Cary, NC: The SAS Institute; 1994.Google Scholar
18.Kleinbaum, DG, Kupper, LL, Morgenstern, H. Information bias. In: Epidemiologic Research. New York, NY: John Wiley & Sons, Inc.; 1982:220241.Google Scholar
19.Klein, GM, Seland, TP, Barclay, L, Van Orman, A. An epidemiological study of multiple sclerosis in the Crows Nest Pass and Cardston Regions of Southern Alberta. Can J Neurol Sci. 1990;17:41.Google Scholar
20.Warren, S, Warren, KG. Prevalence of multiple sclerosis in Barrhead County, Alberta, Canada. Can J Neurol Sci. 1992;19:7275.Google Scholar
21.Sweeney, VP, Sadovnick, AD, Brandejs, V. Prevalence of multiple sclerosis in British Columbia. Can J Neurol Sci. 1986;13:4751.Google Scholar
22.Hader, WJ, Elliot, M, Ebers, GC. Epidemiology of multiple sclerosis in London and Middlesex County, Ontario, Canada. Neurology. 1988;38:617621.Google Scholar
23.Poskanzer, DC, Walker, AM, Yonkondy, J, Sheridan, JL. Studies in the epidemiology of multiple sclerosis in the Orkney and Shetland Islands. Neurology. 1976;26:1417.CrossRefGoogle ScholarPubMed
24.Offord, DR, Boyle, MH, Campbell, D, Goering, P, Lin, E, Wong, Met al. One year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry. 1996;41:559563.Google Scholar
25.Beaudet, MP. Depression. Health Reports. 1996;7:1124.Google Scholar