TY - JOUR
T1 - The incidence and prevalence of psychiatric disorders in multiple sclerosis
T2 - a systematic review
AU - Marrie, Ruth Ann
AU - Reingold, Stephen
AU - Cohen, Jeffrey
AU - Stuve, Olaf
AU - Trojano, Maria
AU - Sorensen, Per Soelberg
AU - Cutter, Gary
AU - Reider, Nadia
N1 - © The Author(s), 2015.
PY - 2015/3/16
Y1 - 2015/3/16
N2 - Background: Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). Objectives: The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies. Methods: We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I2 statistic, and conducted meta-analyses. Results: We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%10.3%) for psychosis. Conclusion: This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.
AB - Background: Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). Objectives: The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies. Methods: We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I2 statistic, and conducted meta-analyses. Results: We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%10.3%) for psychosis. Conclusion: This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.
KW - Comorbidity
KW - Humans
KW - Incidence
KW - Mental Disorders
KW - Multiple Sclerosis
KW - Prevalence
U2 - 10.1177/1352458514564487
DO - 10.1177/1352458514564487
M3 - Review
C2 - 25583845
SN - 1352-4585
VL - 21
SP - 305
EP - 317
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 3
ER -
