Multiple sclerosis (MS) patients with depression or bipolar disorder may be at higher risk of becoming incapacitated and seeing their disability worsen faster, according to a Swedish study.
A depressive state may increase the central nervous system response’s to inflammation and accelerate the progression of MS; if true, more care should be taken in treating these types of disorders in the MS population, researchers found.
The findings were presented Oct. 10 by Stefanie Binzer, MD, at Karolinska Institutet, Sweden, at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany. The presentation was titled “The effect of depression and bipolar disorder on multiple sclerosis disability worsening.”
“Mood disorders are highly prevalent in the MS population, but their impact on MS disability worsening has not yet been established,” Binzer said in her presentation.
Mood disorders, including psychiatric and emotional disorders such as depression, are known to be “associated with reduced quality of life, and are a major risk factor for suicidality,” she said.
To further understand the impact of mood disorders on MS, researchers at the Department of Clinical Neuroscience, Karolinska Institutet conducted a study to find out whether depression and bipolar disorder are associated with disability worsening in MS.
The team compared the risk of disability progression (assessed through the expanded disability status scale, or EDSS) and conversion to secondary progressive MS (SPMS) in MS patients with depression or bipolar disorder to that of patients without these conditions.
The study was based on the analysis of clinical data from 15,541 patients enrolled in the Swedish National MS registry (SMSreg). Among this sample, 1,320 had at least one diagnosis of depression, 271 had at least one diagnosis of bipolar disorder, and 4,921 had been prescribed selective serotonin reuptake inhibitors (SSRI), a commonly used class of antidepressant medications, at least once.
The analysis revealed that patients taking SSRIs were at a significantly higher risk of being increasingly disabled. Specifically, they were 1.4 times, 1.97 times, and 2.2 times more likely of reaching sustained EDSS scores of 3, 4 and 6 (the higher the score, the greater the disability level).
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