Mental comorbidity and multiple sclerosis: validating administrative data to support population-based surveillance

Marrie, Ruth Ann; Fisk, John D.; Yu, Bo; Leung, Stella; Elliott, Lawrence; Caetano, Patrícia; Warren, Sharon; Evans, Charity; Wolfson, Christina; Svenson, Lawrence W.; Tremlett, Helen; Blanchard, James; Patten, Scott B.

doi:10.1186/1471-2377-13-16

Cited by 133 publications

(169 citation statements)

References 29 publications

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“…We limited our selection of physical conditions to those with a validated algorithm that could identify them from administrative data (Marrie et al. 2012, 2013a,b,c). Validated algorithms (Marrie et al.…”

Section: Methodsmentioning

confidence: 99%

“…Validated algorithms (Marrie et al. 2012, 2013a,b,c) were applied to identify depression, anxiety disorders, and bipolar disorder, as well as chronic lung disease, diabetes, epilepsy, fibromyalgia, hyperlipidemia, hypertension, IBD, and IHD. Because all physical comorbidities were chronic conditions, once an individual met the case definition for a condition, they were considered affected thereafter if alive and residing in Alberta.…”

Section: Methodsmentioning

confidence: 99%

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Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

et al. 2016

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BackgroundRisk factors for psychiatric comorbidity in multiple sclerosis (MS) are poorly understood.ObjectiveWe 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.MethodsUsing 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.ResultsIn both populations, men had a lower risk of depression and anxiety disorders than women, as did individuals who were ≥45 years versus <45 years at the index date. The risk of bipolar disorder declined with increasing age. The risks of incident depression (HR 1.92; 1.82–2.04), anxiety disorders (HR 1.52; 1.42–1.63), and bipolar disorder (HR 2.67; 2.29–3.11) were higher in the MS population than the matched population. These associations persisted essentially unchanged after adjustment for covariates including physical comorbidities. Multiple physical comorbidities were associated with psychiatric disorders in both populations.ConclusionPersons with MS are at increased risk of psychiatric comorbidity generally, and some physical comorbidities are associated with additional risk.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

et al. 2016

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“…However, we have found in previous studies of MS that our findings regarding the relative risk of psychiatric comorbidity after MS diagnosis and temporal trends are consistent across other Canadian provinces (Marrie et al 2015b). Administrative data are not collected for research, but we have validated our approaches to identifying IBD, MS, RA and psychiatric comorbidity using these data (Bernstein et al 1999;Marrie et al 2010;Marrie et al 2013;Marrie et al 2016). These data only capture individuals who have sought care through hospitals or physician visits and do not capture individuals with psychiatric disorders diagnosed by non-physician mental health providers, nor those who have not sought any treatment, although this would affect individuals with and without IMID.…”

Section: Discussionmentioning

confidence: 99%

“…Using case definitions developed and validated in MS and IBD populations (Marrie et al 2013;Marrie et al 2016), we identified individuals in each cohort with depression, anxiety disorder, bipolar disorder, schizophrenia and any psychiatric disorder (51 of depression, anxiety disorder, bipolar disorder, schizophrenia) (Supplementary Table S1). For each psychiatric disorder, we assigned the diagnosis date as the date of first health claim for that disorder.…”

Section: Psychiatric Disordersmentioning

confidence: 99%

Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease

Marrie

Walld

Bolton

et al. 2017

Epidemiol Psychiatr Sci

105

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Aims. After the diagnosis of immune-mediated inflammatory diseases (IMID) such as inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA), the incidence of psychiatric comorbidity is increased relative to the general population. We aimed to determine whether the incidence of psychiatric disorders is increased in the 5 years before the diagnosis of IMID as compared with the general population.Methods. Using population-based administrative health data from the Canadian province of Manitoba, we identified all persons with incident IBD, MS and RA between 1989 and 2012, and cohorts from the general population matched 5 : 1 on year of birth, sex and region to each disease cohort. We identified members of these groups with at least 5 years of residency before and after the IMID diagnosis date. We applied validated algorithms for depression, anxiety disorders, bipolar disorder, schizophrenia, and any psychiatric disorder to determine the annual incidence of these conditions in the 5-year periods before and after the diagnosis year.Results. We identified 12 141 incident cases of IMID (3766 IBD, 2190 MS, 6350 RA) and 65 424 matched individuals. As early as 5 years before diagnosis, the incidence of depression [incidence rate ratio (IRR) 1.54; 95% CI 1.30-1.84) and anxiety disorders (IRR 1.30; 95% CI 1.12-1.51) were elevated in the IMID cohort as compared with the matched cohort. Similar results were obtained for each of the IBD, MS and RA cohorts. The incidence of bipolar disorder was elevated beginning 3 years before IMID diagnosis (IRR 1.63; 95% CI 1.10-2.40).Conclusion. The incidence of psychiatric comorbidity is elevated in the IMID population as compared with a matched population as early as 5 years before diagnosis. Future studies should elucidate whether this reflects shared risk factors for psychiatric disorders and IMID, a shared final common inflammatory pathway or other aetiology.

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“…18 Although IRB approval was not necessary, it was received on September 4, 2015, from the Cleveland Clinic IRB.…”

Section: Comorbidity In Msmentioning

confidence: 99%

Antidepressant Drug Treatment in Association with Multiple Sclerosis Disease-Modifying Therapy

Mirsky¹,

Marrie²,

Rae-Grant³

2016

International Journal of MS Care

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Mental comorbidity and multiple sclerosis: validating administrative data to support population-based surveillance

Cited by 133 publications

References 29 publications

Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis

Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease

Antidepressant Drug Treatment in Association with Multiple Sclerosis Disease-Modifying Therapy

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