title: Psychiatric co-morbidity in multiple sclerosis: The risk of depression and anxiety before and after MS diagnosis.
abstract: BACKGROUND
  Studies of depression and anxiety in multiple sclerosis (MS) patients have reported higher rates in MS patients than the general population.
  
  
  OBJECTIVE
  To estimate the risk of depression and anxiety and the use of tricyclic antidepressant and selective serotonin reuptake inhibitors (SSRI) prescriptions, in the pre-diagnostic and the post-diagnostic period of MS compared to the background population.
  
  
  METHODS
  A cohort of 5084 MS patients was included and matched with a control population of 24,771 persons linked to nationwide registers. Logistic regression analyses were performed estimating odds ratios (OR).
  
  
  RESULTS
  In the pre-diagnostic period, the OR for having a diagnosis of depression and anxiety is 1.4 (95% confidence interval (CI) =1.05-1.88), and the OR of redemption prescriptions of TCAs is 1.90 (CI=1.54-2.34) and OR is 1.34 (CI= 1.20-1.51) for SSRI. In the post-diagnostic period the OR is 1.23 (CI= 0.92-1.64) for depression and anxiety diagnosis. The OR is 6.70 (CI=5.81-7.72) for TCA and OR is 2.46 (CI= 2.25-2.69) for SSRI.
  
  
  CONCLUSIONS
  During both the pre- diagnostic and post-diagnostic period, MS patient have increased risk of depression and anxiety diagnoses and redemption of antidepressant and anxiolytic prescriptions, compared to the background population.
authors.affiliation: Institute of Regional Health Research. University of Southern Denmark/ MS-clinic (Sønderborg, Esbjerg, Vejle) of Southern Jutland, Department of Neurology, Sønderborg, Denmark. Research Unit of Mental Health, Odense,Åbenrå, Denmark Huong.Hoang@rsyd.dk.
authors.forename: Huong
authors.initials: H
authors.lastname: Hoang
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Bjarne
authors.initials: B
authors.lastname: Laursen
authors.affiliation: Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark/ Research Unit of Mental Health, Åbenrå, Odense, Denmark. Åbenrå, Denmark.
authors.forename: Elsebeth N
authors.initials: EN
authors.lastname: Stenager
authors.affiliation: Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark/ MS-clinic (Sønderborg, Esbjerg, Vejle) of Southern Jutland, Department of Neurology, Sønderborg, Denmark.
authors.forename: Egon
authors.initials: E
authors.lastname: Stenager
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D016017:Odds Ratio; D015995:Prevalence
chemical_list: D000928:Antidepressive Agents
keywords: Multiple sclerosis; SSRI; TCA; antidepressant; anxiety; depression; psychiatric comorbidity