TY - JOUR
T1 - Psychiatric morbidity develops after onset of pediatric multiple sclerosis
T2 - A Danish nationwide population-based study
AU - Spangsberg Boesen, Magnus
AU - Thygesen, Lau Caspar
AU - Uldall, Peter Vilhelm
AU - Eriksson, Frank
AU - Born, Alfred Peter
AU - Blinkenberg, Morten
AU - Koch-Henriksen, Nils
AU - Greisen, Gorm
AU - Magyari, Melinda
N1 - Copyright © 2017 Elsevier B.V. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
KW - Journal Article
U2 - 10.1016/j.msard.2017.10.018
DO - 10.1016/j.msard.2017.10.018
M3 - Journal article
C2 - 29121513
SN - 2211-0348
VL - 19
SP - 30
EP - 34
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
ER -