Differences in the burden of psychiatric comorbidity in MS vs the general population.
Differences in the burden of psychiatric comorbidity in MS vs the general population.
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DOI：
10.1212/wnl.0000000000002174
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发表时间：
2015-12-01
期刊：
影响因子：
9.9
通讯作者：
CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis
中科院分区：
文献类型：
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作者：
Marrie RA;Fisk JD;Tremlett H;Wolfson C;Warren S;Tennakoon A;Leung S;Patten SB;CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis
我们的目的是比较多发性硬化症（MS）人群和年龄、性别和地理区域相匹配的对照人群中精神科合并症的发病率和患病率。使用来自加拿大4个省的基于人口的行政健康数据，我们确定了2个队列：44，452名MS患者和220，849名年龄，性别和地理区域匹配的对照组。我们应用经过验证的病例定义来估计1995年至2005年抑郁症、焦虑症、双相情感障碍和精神分裂症的发病率和患病率。我们使用荟萃分析汇总了各省的结果。在MS病例中，31，757例（71.3%）为女性，索引日期的平均（SD）年龄为43.8（13.7）岁。2005年，每10万名MS患者中抑郁症的年发病率为979人，焦虑症的发病率为638人，双相情感障碍的发病率为328人，精神分裂症的发病率为60人。MS人群中所有疾病的发病率和患病率估计值均高于匹配人群。尽管两个人群中女性抑郁症的发病率均高于男性，但MS人群中的性别发病率差异（发病率比1.26; 95%置信区间：1.07-1.49）低于匹配人群（发病率比1.50; 95%置信区间：1.21-1.86）。发病率随时间推移保持稳定，而流行率略有上升。精神科合并症在MS中很常见，并且比匹配人群更频繁地影响MS人群，尽管发病率随时间推移而稳定。男性MS患者在发展MS时比女性面临更大的抑郁负担。
We aimed to compare the incidence and prevalence of psychiatric comorbidity in the multiple sclerosis (MS) population and in controls matched for age, sex, and geographic area. Using population-based administrative health data from 4 Canadian provinces, we identified 2 cohorts: 44,452 persons with MS and 220,849 controls matched for age, sex, and geographic area. We applied validated case definitions to estimate the incidence and prevalence of depression, anxiety, bipolar disorder, and schizophrenia from 1995 to 2005. We pooled the results across provinces using meta-analyses. Of the MS cases, 31,757 (71.3%) were women with a mean (SD) age at the index date of 43.8 (13.7) years. In 2005, the annual incidence of depression per 100,000 persons with MS was 979 while the incidence of anxiety was 638, of bipolar disorder was 328, and of schizophrenia was 60. The incidence and prevalence estimates of all conditions were higher in the MS population than in the matched population. Although the incidence of depression was higher among women than men in both populations, the disparity in the incidence rates between the sexes was lower in the MS population (incidence rate ratio 1.26; 95% confidence interval: 1.07–1.49) than in the matched population (incidence rate ratio 1.50; 95% confidence interval: 1.21–1.86). Incidence rates were stable over time while prevalence increased slightly. Psychiatric comorbidity is common in MS, and more frequently affected the MS population than a matched population, although the incidence was stable over time. Men with MS face a disproportionately greater relative burden of depression when they develop MS than women.