Anxiety and depression part of MS prodrome

The rate of psychiatric symptoms such as anxiety and depression is higher in people during the five-year lead up to diagnosis with multiple sclerosis (MS) than it is in healthy people, a new analysis has found. This mean psychiatric morbidity is a significant feature of the MS prodrome – the name for the period before disease onset.

Mental health problems are common among the MS population. But before diagnosis many patients notice health changes which aren’t suggestive of MS, including sleep disorders. This study set out to see if psychiatric symptoms were implicated.

Researchers analysed the data from 6,863 Patients with MS, matched for sex, age and location with up to five healthy people from the general population who were the control group.

They found depression, bipolar disorder, anxiety, and schizophrenia had a significantly higher prevalence in the MS group than the control for the five years before disease onset. The prevalence seemed to get higher as the onset date approached.

A total of 28% of the MS participants and 15% of the control group had psychiatric issues during the five-year period. This is an 88% greater risk for the MS group.

Depression was the most common symptom, anxiety was the second.

The team also noted mental health-related doctor visits were 125% more frequent in MS patients than the controls and visits to psychiatrists were 150% more common in the year before diagnosis.

Hospital admissions were also up for MS patients by 130% five years prior to onset, rising to almost 200% by one year to onset.

Psychiatric medication prescriptions were up by 75% five years prior and 100% at one year to onset.

The researchers said the results were somewhat limited by the data captured being from public healthcare which means the patients were actively seeking help for their symptoms, but this would probably be equally true across the control group too. The findings demonstrated that the psychiatric issues that appear before MS onset are an “important contributor to increased healthcare use in the MS prodrome.”