Highlights
- •Taken together, psychiatric morbidity seems to commence after onset of pediatric MS.
- •No association was found between psychiatric morbidity and the subsequent rate of MS (p=0.53).
- •Children with MS had a two times higher hazard for psychiatric co-morbidity compared with children without MS (p<0.001).
Abstract
Background
Pediatric-onset multiple sclerosis (MS) affects life at a stage vital for social and
educational achievements and psychiatric co-morbidity is common after MS onset. Few
studies have examined psychiatric morbidity before MS onset.
Methods
In this nationwide study, detailed case ascertainment was performed in all children
with pediatric MS, including chart review. For each MS patient, we selected five controls
using density sampling from the entire Danish population, matching controls to children
with MS by sex and birthdate. We analyzed data as a nested case-control study with
psychiatric morbidity as exposure and MS as outcome, and a matched cohort study with
MS as exposure and psychiatric co-morbidity as outcome. Hazard ratios (HR) including
95% confidence intervals (CI) were estimated using Cox regression.
Results
We identified 212 children with MS and 1060 controls. No association between psychiatric
morbidity and the rate of MS was found before MS onset. After MS onset, children with
MS had two times higher hazard for psychiatric co-morbidity compared with children
without MS (HR=2.0; 95% CI=1.3–3.1; p<0.001).
Conclusion
Psychiatric morbidity seems to commence after MS onset, making screening for neuropsychiatric
conditions pertinent in newly-diagnosed children with MS.
Abbreviations:
ATC (Anatomical Therapeutic Chemical), DMSR (Danish Multiple Sclerosis Registry), CI (Confidence intervals), HR (Hazard Ratio), ICD (International classification of diseases), NPR (National Patient Register), MS (Multiple Sclerosis), CNS (Central Nervous System)Keywords
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Article info
Publication history
Published online: October 31, 2017
Accepted:
October 29,
2017
Received in revised form:
October 4,
2017
Received:
August 14,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
