The risk of depression and anxiety in multiple sclerosis and neuromyelitis optica spectrum disroder: a nationwide cohort study in South Korea

초록

Introduction: Depression/anxiety are common psychiatric comorbidities in multiple sclerosis and neuromyelitis optica spectrum disorder. Although there have been many studies on the prevalence of depression/anxiety in MS, the risk of developing depression/anxiety in MS or NMOSD is still unknown. Objectives/Aims: In the present population-based cohort study, we investigated the incidence of depression and anxiety in patients with MS/NMOSD using the Korean National Health Insurance Service (KNHIS) database. Methods: MS and NMOSD cohorts were collected from the Korean National Health Insurance Service (NHIS) between January 1, 2010, and December 31, 2017, using International Classification of Diseases 10th revision diagnosis codes. We investigated the risk of developing depression/anxiety in patients with MS and NMOSD compared to their 1:5 matched control group for age, gender, hypertension, diabetes, and dyslipidemia. Results: Adjusted hazard ratios (aHRs) of depression were 3.21 (95% confidence interval [CI], 2.57−4.03) in MS and 2.17 (95% CI 1.71−2.76) in NMOSD patients. aHRs of anxiety were 1.83 (95% CI 1.50−2.23) in MS and 1.56 (95% CI 1.27 −1.92) in NMOSD patients. Sex-stratified differences in the risk of depression were not found in both MS and NMOSD, but the increased risk of developing anxiety was more increased in male MS patients than in female MS patients (aHR 2.27, 95% CI 1.71−3.01; aHR 1.52, 95% CI 1.16−2.00; P for interaction 0.045). When stratified by age, aHR of depression was higher in a younger age group for MS and NMOSD (P for interaction 0.048 and 0.005, respectively). There was no significant effect on modification by the presence of comorbidities (diabetes, hypertension, dyslipidemia, myocardial infarction, stroke, congestive heart failure, end-stage renal disease, or cancer) on the risk of depression or anxiety in both MS and NMOSD group. Conclusion: Our findings suggest that the depression/anxiety risk are high in MS/NMOSD patients compared with the control population, and the risk was more prominent in those who were younger. Disclosure of interest: Ju-Hong Min has lectured, consulted and received Honoria from Bayer Schering Pharma, Merck Serono, Biogen Idec, Sanofi Genzyme, Teva- Handok, UCB, Samsung Bioepis, Mitsubishi Tanabe Pharma and Roche and has received a grant from the National Research Foundation of Korea and SMC Research and Development Grant. The other authors report no competing interests.