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Mult Scler. 2015 Mar;21(3):305-17. doi: 10.1177/1352458514564487. Epub 2015 Jan 12.

The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review.

Author information

1
Department of Internal Medicine, University of Manitoba, Canada/Department of Community Health Sciences, University of Manitoba, Canada rmarrie@hsc.mb.ca.
2
Scientific and Clinical Review Associates, LLC, USA.
3
Mellen Center for MS Treatment and Research, Cleveland Clinic, USA.
4
Department of Neurology and Neurotherapeutics, University of Texas Southwestern, USA.
5
Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
6
Department of Neurology, Copenhagen University Hospital Rigshospitalet, Denmark.
7
Department of Biostatistics, University of Alabama at Birmingham, USA.
8
Department of Community Health Sciences, University of Manitoba, Canada.

Abstract

BACKGROUND:

Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS).

OBJECTIVES:

The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies.

METHODS:

We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I² statistic, and conducted meta-analyses.

RESULTS:

We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis.

CONCLUSION:

This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.

KEYWORDS:

Multiple sclerosis; anxiety; bipolar disorder; comorbidity; depression; incidence; prevalence; psychosis; systematic review

PMID:
25583845
PMCID:
PMC4429164
DOI:
10.1177/1352458514564487
[Indexed for MEDLINE]
Free PMC Article

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