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Hospital-based psychiatric service utilization and morbidity in multiple sclerosis
J D FisK1, S A Morehouse, M G Brown
1Department of Psychology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
Summary
Hospitalized patients with multiple sclerosis (MS) have double the prevalence of bipolar disorder and depression compared to the general hospital population. Suicide attempts were also significantly more frequent in MS patients.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Multiple sclerosis (MS) is frequently associated with psychiatric conditions, yet population-based prevalence data are scarce.
- Accurate prevalence estimates are crucial for designing effective treatment trials for MS.
- This study investigated psychiatric disorders in individuals utilizing hospital services in Nova Scotia.
Purpose of the Study:
- To determine the prevalence of bipolar disorder, depression, and suicide attempts in hospital service users with MS.
- To compare these prevalence rates between MS patients and the non-MS hospital user population.
Main Methods:
- Utilized linked hospital separation records from Nova Scotia spanning three years (1992/93-1994/95).
- Extracted data on diagnoses and healthcare utilization for all hospital admissions.
Main Results:
- Prevalence of bipolar disorder was 1.97% and depression was 4.27% in hospitalized MS patients, significantly higher than non-MS users (0.92% and 2.04%).
- Bipolar disorder and depression constituted over half of primary psychiatric diagnoses for MS patients.
- The frequency of suicide attempts in the total MS population was over three times higher than in the general population.
Conclusions:
- Bipolar disorder and depression are twice as prevalent in hospitalized MS patients compared to general hospital users.
- Suicide attempts are at least three times more frequent in the MS population.
- Psychiatric morbidity and service utilization are critical factors in managing multiple sclerosis care.