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Psychiatric disorders in children with demyelinating diseases of the central nervous system

Julia Pakpoor1, Raph Goldacre1, Klaus Schmierer2

  • 1Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|July 6, 2017
PubMed

Insights

Pediatric central nervous system (CNS) demyelinating diseases, including multiple sclerosis (MS), are linked to higher rates of psychiatric disorders. Early mental health intervention is crucial for affected children.

Area of Science:

  • Neurology
  • Child Psychiatry
  • Epidemiology

Background:

  • The psychiatric profile in pediatric multiple sclerosis (MS) may differ from adults.
  • Understanding the co-occurrence of psychiatric disorders and CNS demyelinating diseases in children is essential.

Purpose of the Study:

  • To assess the risk of psychiatric disorders in children diagnosed with MS and other central nervous system (CNS) demyelinating diseases.
  • To investigate the association between pediatric CNS demyelinating diseases and psychiatric conditions.

Main Methods:

  • Utilized linked English Hospital Episode Statistics and mortality data from 1999-2011.
  • Constructed cohorts of children with MS and other CNS demyelinating diseases, analyzing subsequent psychiatric diagnoses.
  • Compared psychiatric disorder rates in affected children to a reference cohort.

Main Results:

  • Children with CNS demyelinating diseases showed increased rates of psychotic disorders (RR=5.77), anxiety/stress/somatoform disorders (RR=2.38), intellectual disability (RR=6.56), and behavioral disorders (RR=8.99).
  • The pediatric MS cohort exhibited elevated risks for psychotic disorders (RR=10.76), mood disorders (RR=2.57), and intellectual disability (RR=6.08).
  • Reverse analysis indicated higher rates of CNS demyelinating disease following diagnoses of anxiety, ADHD, autism, intellectual disability, and behavioral disorders.

Conclusions:

  • This national database analysis strongly supports an association between pediatric CNS demyelinating diseases and psychiatric disorders.
  • Highlights the critical need for early and integrated mental health support for children with these neurological conditions.
Abstract

Keywords:
Multiple sclerosisdemyelinationepidemiologypediatricpsychiatry

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