Hospital-based psychiatric service utilization and morbidity in multiple sclerosis.
BACKGROUND
Despite the common association of psychiatric morbidity and multiple sclerosis (MS), population-based prevalence estimates of these disorders are limited. Such estimates are of particular importance to those conducting trials of interventions for the treatment of MS. This study examined the prevalence of bipolar disorder, depression, and attempted suicide among hospital service utilizers in Nova Scotia and compared these measures for the MS and non-MS population.


METHODS
Data regarding diagnosis and utilization were extracted from two linked databases which included all hospital separation records for Nova Scotia over a 3 year period (1992/93-1994/95).


RESULTS
The prevalence of bipolar disorder in hospitalized MS patients was 1.97% and depression was 4.27%. These rates were significantly higher than the 0.92% and 2.04%, respectively, for the non-MS hospital utilizers. These diagnoses also accounted for more than half of the primary diagnostic codes for psychiatric service separations by MS patients. The proportion of total hospital utilization which was accounted for by psychiatric services did not differ between MS and non-MS utilizers. While suicide attempts were rare, the estimated frequency of suicide attempts in the total MS population was more than three times that of the general population.


CONCLUSIONS
Bipolar disorder and depression were twice as prevalent in hospitalized MS patients as in the general population of hospital utilizers while the estimated frequency of suicide attempts was at least three times greater. These results illustrate that psychiatric morbidity and service utilization are important considerations in the care of MS patients.
FisK
J D
JD
Department of Psychology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
Morehouse
S A
SA
Brown
M G
MG
Skedgel
C
C
Murray
T J
TJ
D001714:Bipolar Disorder / Q000150:complications / Q000453:epidemiology; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D009674:Nova Scotia / Q000453:epidemiology; D011567:Psychiatric Department, Hospital; D013406:Suicide, Attempted