{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:39:39Z","timestamp":1769819979848,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T00:00:00Z","timestamp":1467158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CBG 101829"],"award-info":[{"award-number":["CBG 101829"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000196","name":"Canada Foundation for Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009003","name":"Hotchkiss Brain Institute, University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009003","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008459","name":"University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000261","name":"Multiple Sclerosis Society of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000261","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000890","name":"National Multiple Sclerosis Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Risk factors for psychiatric comorbidity in multiple sclerosis (MS) are poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We evaluated the association between physical comorbidity and incident depression, anxiety disorder, and bipolar disorder in a <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> population relative to a matched general population cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using population\u2010based administrative data from Alberta, Canada we identified 9624 persons with <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>, and 41,194 matches. Using validated case definitions, we estimated the incidence of depression, anxiety disorder, and bipolar disorder, and their association with physical comorbidities using Cox regression, adjusting for age, sex, socioeconomic status, and index year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In both populations, men had a lower risk of depression and anxiety disorders than women, as did individuals who were \u226545\u00a0years versus &lt;45\u00a0years at the index date. The risk of bipolar disorder declined with increasing age. The risks of incident depression (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.92; 1.82\u20132.04), anxiety disorders (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.52; 1.42\u20131.63), and bipolar disorder (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.67; 2.29\u20133.11) were higher in the <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> population than the matched population. These associations persisted essentially unchanged after adjustment for covariates including physical comorbidities. Multiple physical comorbidities were associated with psychiatric disorders in both populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Persons with <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> are at increased risk of psychiatric comorbidity generally, and some physical comorbidities are associated with additional risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.493","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T18:38:14Z","timestamp":1467225494000},"source":"Crossref","is-referenced-by-count":24,"title":["Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis"],"prefix":"10.1002","volume":"6","author":[{"given":"Ruth Ann","family":"Marrie","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada"},{"name":"Department of Community Health Sciences University of Manitoba Winnipeg Manitoba Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott B.","family":"Patten","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences and Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence W.","family":"Svenson","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary Alberta Canada"},{"name":"School of Public Health University of Alberta Edmonton Alberta Canada"},{"name":"Surveillance and Assessment Alberta Health Edmonton Alberta 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Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Warren","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Medicine University of Alberta Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Profetto\u2010McGrath","sequence":"additional","affiliation":[{"name":"Faculty of Nursing University of Alberta Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Fisk","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Medicine Dalhousie University Halifax Nova Scotia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple 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