Sex differences in comorbidity at diagnosis of multiple sclerosis

Abstract

Objective:To determine the prevalence of comorbidity in the multiple sclerosis (MS) population at the time of MS diagnosis. We also compared the prevalence of comorbidity in the MS population to that in a matched cohort from the general population.Methods:Using population-based administrative health data from 4 Canadian provinces, we identified 23,382 incident MS cases and 116,638 age-, sex-, and geographically matched controls. We estimated the prevalence of hypertension, diabetes, hyperlipidemia, heart disease, chronic lung disease, epilepsy, fibromyalgia, inflammatory bowel disease, depression, anxiety, bipolar disorder, and schizophrenia at MS diagnosis using validated case definitions. We compared the populations using rate ratios.Results:Of the MS cases, 16,803 (71.9%) were female. The most prevalent comorbidity was depression (19.1%). Compared to the matched population, all comorbidities except hyperlipidemia were more common in the MS population. Relative to the matched populations, the prevalence of hypertension was 16% higher for women with MS and 48% higher for men with MS, thus there was a disproportionately higher prevalence of hypertension in men with MS than women. Men with MS also had a disproportionately higher prevalence than women with MS for diabetes, epilepsy, depression, and anxiety.Conclusions:Comorbidity is more common than expected in MS, even around the time of diagnosis. The prevalence of psychiatric comorbidity is particularly high and highlights the need for clinical attention to this issue. The observed sex-specific differences in the burden of comorbidity in MS, which differ from those in the matched population, warrant further investigation.

Comorbidity in multiple sclerosis: Past, present and future

“…While most of the studies of comorbidity prevalence focused on prevalent MS cohorts, several focused on cohorts of persons with newly diagnosed MS. Among these individuals, the most common physical comorbidities are hypertension, chronic lung disease and hyperlipidemia [20,21]. Moreover, the prevalence of multiple comorbidities is higher in the MS population than in an age-, sex-and geographically-matched non-MS population at least five years before MS diagnosis [20].…”

Vitamin-D Deficiency As a Potential Environmental Risk Factor in Multiple Sclerosis, Schizophrenia, and Autism

“…This study demonstrated the involvement of the same HLA alleles in MS and schizophrenia, but with an opposite directionality of effect. Intriguingly, recent population-based studies found that several psychiatric comorbidities including schizophrenia, anxiety, depression, and bipolar disorder were more common in MS population than in a matched control cohort (79, 80), as were white matter changes and myelin-related dysfunction in schizophrenia (81). …”

Psychiatric Symptoms and Disorders in Multiple Sclerosis: Review

“…6 Depresyon, MS'de diğer kronik nörolojik hastalıklara göre daha sık görülmektedir. 4 Johansson ve ark.nın, yakın zamanda yapmış oldukları ça-lışmada, MS hastalarında depresyonun görülme sıklığının arttığı sonucuna ulaşmışlardır. 8 Bu sonucun nedenlerini de hastalığın inflamatuar mekanizması ve ayrıca hastaların karşılaştığı fiziksel ve sosyal zorluklar olarak bildirmişlerdir.…”

“…Erkek hastalarda diyabet, epilepsi, depresyon ve anksiyete kadınlara göre daha yük-sek prevalansta saptanmıştır. 4 Hastalığın patofizyolojisindeki inflamasyonun çalışmalarda psikiyatrik hastalıklara zemin oluş-turduğu saptanmışsa da nörolojik açıdan engellilik ve hayat kalitesinin düşmesi, hastalarda özellikle depresyon ve anksiyetenin görülme sıklığını artırmaktadır. 5,6 Bu çalışmada, MS'de görülen psikiyatrik bulgular ve bozukluklar, yaklaşım ve patofizyolojisi tartışılmıştır.…”