title: Prescribed psychiatric medication among multiple sclerosis patients before and after disability pension: a register study with matched controls.
abstract: Many multiple sclerosis (MS) patients of working ages have psychiatric comorbidity, and 60 % are on disability pension (DP). It is unknown how DP is associated with MS patients' mental health. The objective of this study was to investigate the association between prescriptions of psychiatric medication and time before and after receiving full-time DP in MS patients compared with matched controls.
  
  
  
  Nationwide Swedish registers were used to identify 3836 MS patients who were granted DP in 2000-2012 and 19,180 DP controls matched on socio-demographic variables by propensity scores. Patients and controls were organized in groups by year granted DP. Adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated for being prescribed selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, or sleeping agents in 2006.
  
  
  
  Both patients and controls, who were not yet on DP in the study year of 2006, had lower OR compared with those who were granted DP in the same year. The OR increased when being closer to DP. MS patients, who had been granted DP 5-6 years earlier, had a higher risk for prescription of benzodiazepines (OR 1.72; 95 % CI 1.16-2.57) than controls (OR 1.14; 95 % CI 1.14-1.18). These patients also had a higher risk for SSRI prescription when compared directly with controls (OR 1.76; 95 % CI 1.44-2.15).
  
  
  
  MS patients have substantially higher odds ratios for being prescribed psychiatric drugs after DP than other disability pensioners. Further research on the association of DP with the mental health of MS patients is warranted.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Center for Psychiatry Research, Karolinska Universitetssjukhuset R5:00, 171 77, Stockholm, Sweden. philip.brenner@ki.se.
authors.forename: Philip
authors.initials: P
authors.lastname: Brenner
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Ellenor
authors.initials: E
authors.lastname: Mittendorfer-Rutz
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Center for Psychiatry Research, Karolinska Universitetssjukhuset R5:00, 171 77, Stockholm, Sweden.|Department of Clinical Sciences, Umeå University, Umeå, Sweden.
authors.forename: Jussi
authors.initials: J
authors.lastname: Jokinen
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.affiliation: Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hillert
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.|Red Cross University College, Stockholm, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Tinghög
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D016017:Odds Ratio; D010415:Pensions; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012042:Registries; D013548:Sweden
chemical_list: D011619:Psychotropic Drugs
keywords: Benzodiazepines; Depression; Disability pension; Epidemiology; Hypnotics and sedatives; Multiple sclerosis; Serotonin uptake inhibitors; Sick leave