#ECTRIMS2016 – Children with MS at Considerable Risk of Psychiatric Disorders

Children with multiple sclerosis (MS) or other demyelinating conditions experience psychiatric disorders more often than other kids, and  mental health professionals need to be involved early in their care so that those with these disorders are identified and treated early, a new study reported.

Data from the study, “Risks of psychiatric disorders in children and young adults with demyelinating diseases of the central nervous system: a national record-linkage study,” were presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2016 Congress in London, running Sept. 14–17, as part of the Young Scientific Investigators’ Session 2 on the first day of the congress.

As children with MS develop brain inflammation and damage at a stage in life when the brain is still developing, they are at risk of developing psychiatric disorders as well.

A research team from the University of Oxford used English hospital episode statistics to identify children and adolescents with MS. The team analyzed records of 201 pediatric MS patients, and an additional 1,097 records of young patients with other demyelinating diseases. Researchers also included more than 1.1 million children without these diseases as controls.

Results showed that children with all forms of demyelinating disease were about 5.8 times more likely to develop a psychotic disorder.

The risk was also increased by 2.4 times for anxiety, stress-related and somatoform disorders; 6.6 times for intellectual disability; and 9 times for behavioral disorders. The risk to develop any of the studied psychiatric conditions was increased 1.6 times.

When the team analyzed only those children who had gone at least one year since a first neurological and psychiatric episode, risks were still elevated. Raising the interval to five years, the team could still see elevated risks for psychotic disorders, intellectual disability, and other behavioral conditions.

Looking only at the children with MS, the risk for psychosis was even higher — 10.76 times that of healthy children. MS kids also had a 2.6 times increased risk for mood disorders, and a 6.1 times increased risk for intellectual disability.

Reversing the analysis, that is, exploring whether the presence of a psychiatric disease affected the risk of MS or other demyelinating conditions, researchers found that anxiety, stress-related and somatoform disorders, attention deficit hyperactivity disorder (ADHD), autism, intellectual disability, and other behavioral disorders increased the risk for neurological disease.

“This population-based study reports strong evidence for an association between paediatric CNS [central nervous system] demyelinating diseases and psychiatric disorders. We highlight a need for early involvement of mental health professionals as part of a multi-disciplinary care approach,” the authors concluded in their ECTRIMS’ abstract.