Multiple Comorbidities Prevalent in Multiple Sclerosis Patients

Internal Medicine World ReportJuly 2014

Many patients with multiple sclerosis have numerous comorbid chronic conditions that worsen mental health and increase mortality.

Many patients with multiple sclerosis (MS) have numerous comorbid chronic conditions that worsen mental health and increase mortality, according to a study published in BMC Neurology.

For the study, researchers from the University of Glasgow examined clinical data on 1.7 million Scottish individuals who were registered with 314 general practices and considered to be nationally representative in terms of age, gender, and socioeconomic status. The researchers specifically targeted those aged >25 years, given the small population of MS patients aged ≤25 years.

“Our study focused on MS for various reasons, one of which being that Scotland has the highest prevalence rates for MS worldwide, making the condition of particular interest,” the study’s corresponding author, Robert Simpson, MD, told Internal Medicine World Report. “The MS part of the research is also related to a wider study looking at developing an integrative stress management program for people with MS, which acknowledges and aims to address some of the difficulties that living with multiple comorbid conditions can bring forth.”

The investigators found MS patients had not only higher levels of nervous system comorbidities — such as chronic pain, migraine, and epilepsy – but also more gastrointestinal conditions like constipation and mental health diseases like depression and anxiety. However, those observed in the study demonstrated lower rates of hypertension, coronary heart disease, heart failure, and atrial fibrillation compared to the general population.

“We were most surprised by the finding of lower cardiovascular comorbidities in people with MS, as Scotland has very high rates of cardiovascular diseases, in general,” Simpson said. “We are not sure why this was the case in our study, but it is interesting to note that it echoes similar findings by researchers using the same database to study comorbidity in another long-term condition, namely schizophrenia.”

Overall, the authors concluded an MS diagnosis could be delayed by comorbidities and associated with increased levels of disability.

“Our study highlights that certain patterns of comorbidity are common in people with MS in Scotland, and that there is a strong relationship between increasing physical health comorbidity and associated mental health problems,” Simpson explained. “It also suggests that extra vigilance may be necessary for clinicians, with respect to considering the incidence of cardiovascular comorbidities in people with MS.”

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