Psychiatric visits 146% higher for patients in year before MS onset
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SAN DIEGO — Patients with MS were twice as likely to experience psychiatric morbidity, including depression and anxiety, in the prodromal phase compared with healthy controls, according to research presented at ACTRIMS 2023.
“There (are) emerging studies that have suggested psychiatric disorders may be present prior to recognition of MS, in the period known as the MS prodrome,” Anibal Chertcoff, MD, a postdoctoral fellow in neurology at the University of British Columbia, told attendees.
Chertcoff and colleagues sought to understand psychiatric morbidity, including depression and anxiety, in patients with MS compared with matched controls 5 years prior to MS onset.
Researchers used linked administrative data to identify 6,863 patients with MS matched by sex, year of birth and postal code to 31,865 controls from the general population and determined the prevalence of psychiatric morbidities — specifically depression, anxiety, bipolar disorder and schizophrenia — in MS cases and matched controls 5 years before the first demyelinating claim for MS individuals.
Researchers also compared the number of physician visits for psychiatric morbidity, psychiatric visits and psychiatric-related admissions, as well as psychopharmacological prescriptions in each of the 5 years for each cohort.
According to study results, 73% of the study population were women, and the mean age at the first demyelinating claim was 44 years. Five years before MS onset, 28% of MS cases and 14.9% of controls had at least one type of psychiatric morbidity, with greater odds in MS cases compared with controls (2.28; 95% CI, 2.14-2.42).
In addition, physician visits were 78% higher in year 5 pre-MS onset (adjusted rate ratio = 1.78; 95% CI, 1.59-1.98) and 124% higher 1 year before onset (aRR = 2.24; 95% CI, 2.03-2.49). Psychiatric visits also were higher by 132% in year 5 (aRR = 2.32; 95% CI, 1.85-2.92) and by 146% in the year before onset (aRR = 2.46; 95% CI, 2.04-2.98).
Further, admissions were 129% higher in year 5 pre-MS onset and 197% higher 1 year prior, while prescription dispensations also increased by 72% in year 5 and by 100% in year 1.
“In the 5 years before MS onset, the prevalence of psychiatric morbidity was higher for MS cases versus controls in each of these years,” Chertcoff said during his presentation.