HOSPITAL-BASED PSYCHIATRIC-SERVICE UTILIZATION AND MORBIDITY IN MULTIPLE-SCLEROSIS

Background: Despite the common association of psychiatric morbidity an d multiple sclerosis (MS), population-based prevalence estimates of th ese disorders are limited. Such estimates are of particular importance to those conducting trials of interventions for the treatment of MS. This study examined the prevalence of bipolar disorder, depression, an d attempted suicide among hospital service utilizers in Nova Scotia an d compared these measures for the MS and non-MS population. Methods: D ata regarding diagnosis and utilization were extracted from two linked databases which included all hospital separation records for Nova Sco tia over a 3 year period (1992/93-1994/95). Results: The prevalence of bipolar disorder in hospitalized MS patients was 1.97% and depression was 4.27%, These rates were significantly higher than the 0.92% and 2 .04%, respectively for the non-MS hospital utilizers. These diagnoses also accounted for more than half of the primary diagnostic codes for psychiatric service separations by MS patients. The proportion of tota l hospital utilization which was accounted for by psychiatric services did not differ between MS and non-MS utilizers. While suicide attempt s were rare, the estimated frequency of suicide attempts in the total MS population was more than three times that of the general population . Conclusions: Bipolar disorder and depression were twice as prevalent in hospitalized MS patients as in the general population of hospital utilizers while the estimated frequency of suicide attempts was at lea st three rimes greater. These results illustrate that psychiatric morb idity and service utilization are important considerations in the care of MS patients.