The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic review
Open accessAbstract
BACKGROUND: Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). OBJECTIVES: The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies. METHODS: We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I² statistic, and conducted meta-analyses. RESULTS: We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION: This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.
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A comprehensive systematic review of 118 studies found psychiatric comorbidities in MS were common; prevalence of diagnosed anxiety and depression were estimated at 21.9 and 23.7%, respectively.
“A comprehensive systematic review of 118 studies on psychiatric comorbidities in MS found that psychiatric comorbidities were common; in particular, the prevalence of diagnosed anxiety and depression were estimated at 21.9 and 23.7%, respectively [53].”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [53]
The Abstract Results report 118 studies and prevalence estimates of 21.9% for anxiety and 23.7% for depression among population-based studies; the Discussion says psychiatric comorbidity is common in MS. However, the Results (Psychiatric disorders) show that these estimates combine studies using diagnoses with studies using symptom questionnaires. They are not estimates specifically of diagnosed anxiety and depression. (LLM, conf=0.90)
Experimental — accuracy not yet measuredMS patients show increased levels of anxiety and depression compared to healthy participants, and these conditions affect more than 20% of patients.
“MS patients show increased levels of anxiety and depression compared to healthy participants, and these conditions affect more than 20% of patients [8,21,22,23].”
From Biopsychosocial Correlates of Quality of Life in Multiple Sclerosis Patients (2022) · cites this paper as [23]
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- Authors
- Marrie, R. A., Reingold, S., Cohen, J., Stuve, O., Trojano, M., Sorensen, P. S., Cutter, G., & Reider, N.
- Affiliations
- University of Manitoba (CA)
- Scientific and Clinical Review Associates, LLC, USA
- Cleveland Clinic (US)
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern, USA
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy
- Department of Neurology, Copenhagen University Hospital Rigshospitalet, Denmark
- University of Alabama at Birmingham (US)
- Corresponding author
- Marrie, Ruth Ann
- Venue
- Multiple Sclerosis Journal
- Publisher
- SAGE Publications
- Published
- 2015-01-12
- Volume
- 21
- Issue
- 3
- Pages
- 305-317
- ISSN
- 1352-4585 (ISSN-L)
- 1477-0970
- PMC
- PMC4429164
- OpenAlex
- W2105913548
- Cited by
- 519
- References
- 136
- Citations by year
- 2026: 42 · 2025: 31 · 2024: 45 · 2023: 46 · 2022: 52 · 2021: 68 · 2020: 48 · 2019: 38 · 2018: 43 · 2017: 47 · 2016: 43 · 2015: 16
- FWCI
- 7.28
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Multiple Sclerosis Journal (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- mediaTUM (Technical University of Munich) (submittedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Funders
- U.S. Department of Defense
- National Multiple Sclerosis Society
- Pfizer
- GlaxoSmithKline
- Sanofi
- Gilead Sciences
- Biogen
- Teva Pharmaceutical Industries
- Cleveland Clinic
- Multiple Sclerosis Society of Canada
- Multiple Sclerosis Society
- MedDay Pharmaceuticals
- National Institutes of Health
- Genentech
- EMD Serono
- National Heart, Lung, and Blood Institute
- National Institute of Neurological Disorders and Stroke
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- multiple sclerosis, psychiatric comorbidity, depression, anxiety, alcohol abuse, bipolar disorder, substance abuse, psychosis, incidence, prevalence, quality of life, fatigue
- MeSH terms
- Mental Disorders, Humans, Multiple Sclerosis, Comorbidity, Incidence, Prevalence
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