Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis Ruth Ann Marrie1,2, Scott B. Patten3, Jamie Greenfield4, Lawrence W. Svenson3,5,6, Nathalie Jette3,4,7, Helen Tremlett8, Christina Wolfson9, Sharon Warren10, Joanne Profetto-McGrath11 & John D. Fisk12 for the CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis* 1
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada 3 Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada 4 Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada 5 School of Public Health, University of Alberta, Edmonton, Alberta, Canada 6 Surveillance and Assessment, Alberta Health, Edmonton, Alberta, Canada 7 O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada 8 Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada 9 Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada 10 Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada 11 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada 12 Departments of Psychiatry and Medicine, Dalhousie University, Halifax, Nova Scotia, Canada 2
Keywords administrative data, anxiety, comorbidity, depression, multiple sclerosis Correspondence Ruth Ann Marrie, Health Sciences Center, GF-543, 820 Sherbrook Street, Winnipeg MB R3A 1R9, Canada. Tel: 204 787 4951; Fax: 204 787 1486; E-mail: [email protected] Funding Information This study was supported (in part) by the Canadian Institutes of Health Research (CBG 101829), the Rx & D Health Research Foundation, a Don Paty Career Development award from the Multiple Sclerosis Society of Canada (to RAM), Manitoba Research Chair from Research Manitoba (to RAM), and a Tier 2 Canada Research Chair in Neurological Health Services Research (to NJ). The funding source(s) had no role in the study design, collection, analysis, or interpretation of the data, nor in the decision to submit the article for publication. Received: 15 January 2016; Revised: 8 April 2016; Accepted: 13 April 2016
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
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada 3 Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada 4 Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada 5 School of Public Health, University of Alberta, Edmonton, Alberta, Canada 6 Surveillance and Assessment, Alberta Health, Edmonton, Alberta, Canada 7 O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada 8 Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada 9 Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada 10 Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada 11 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada 12 Departments of Psychiatry and Medicine, Dalhousie University, Halifax, Nova Scotia, Canada 2
Keywords administrative data, anxiety, comorbidity, depression, multiple sclerosis Correspondence Ruth Ann Marrie, Health Sciences Center, GF-543, 820 Sherbrook Street, Winnipeg MB R3A 1R9, Canada. Tel: 204 787 4951; Fax: 204 787 1486; E-mail: [email protected] Funding Information This study was supported (in part) by the Canadian Institutes of Health Research (CBG 101829), the Rx & D Health Research Foundation, a Don Paty Career Development award from the Multiple Sclerosis Society of Canada (to RAM), Manitoba Research Chair from Research Manitoba (to RAM), and a Tier 2 Canada Research Chair in Neurological Health Services Research (to NJ). The funding source(s) had no role in the study design, collection, analysis, or interpretation of the data, nor in the decision to submit the article for publication. Received: 15 January 2016; Revised: 8 April 2016; Accepted: 13 April 2016
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
