Depression readmission risk is elevated in multiple sclerosis compared to other chronic illnesses

Area of Science:

• Neurology
• Psychiatry
• Health Services Research

Background:

• Multiple Sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
• Understanding readmission risks for mental health conditions after hospitalization is crucial for patient outcomes.
• Depression and suicide attempts (SA) are significant concerns in patients with chronic illnesses.

Purpose of the Study:

• To compare the readmission rates for depression or suicide attempt (SA) after an initial hospitalization for MS versus other chronic inflammatory illnesses.
• To identify risk factors associated with depression readmission in MS patients.

Main Methods:

• A retrospective cohort study using the 2013 National Readmissions Database.
• Identified patients with MS, asthma, rheumatoid arthritis (RA), depression, and SA using ICD codes.
• Analyzed index admissions and 90-day readmission rates, calculating hazard ratios (HRs) for depression/SA readmission, adjusting for covariates.

Main Results:

• Multiple Sclerosis (MS) patients had a higher baseline prevalence of depression (24.7%) compared to asthma (15.6%) and RA (14.6%).
• The 90-day depression readmission rate was higher for MS (0.5%) than asthma (0.3%) and RA (0.03%).
• The HR for depression readmission was significantly higher after MS admission versus asthma (1.37) and RA (4.68). No significant difference was found for SA readmission.
• MS patients with psychiatric disease or substance abuse had more than double the HR for depression readmission compared to similar patients with asthma or RA.

Conclusions:

• Hospitalization for MS is associated with an elevated risk of depression readmission compared to asthma and RA.
• Substance use and baseline psychiatric comorbidity are stronger predictors of depression readmission in MS patients.
• These findings highlight the need for targeted mental health support for MS patients, especially those with co-occurring conditions.