{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:41:57Z","timestamp":1753882917453,"version":"3.41.2"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["161L0216"],"award-info":[{"award-number":["161L0216"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003493","name":"Gemeinn\u00fctzige Hertie-Stiftung","doi-asserted-by":"publisher","award":["P1200018"],"award-info":[{"award-number":["P1200018"]}],"id":[{"id":"10.13039\/501100003493","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal - Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Comorbidities in people with multiple sclerosis (PwMS) can affect disease course and quality of life. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p> To investigate comorbidities in the five years after diagnosis, timing of comorbidity occurrence, age and sex effects, and differences between multiple sclerosis (MS) and other chronic autoimmune diseases (AIDs). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> In this retrospective cohort study, we systematically assessed differences in diagnosis frequencies in newly diagnosed PwMS ( n\u2009=\u20099,880) compared to matched controls (noAID, n\u2009=\u200929,640) and individuals with other AIDs (psoriasis, n\u2009=\u200929,640; Crohn's disease, n\u2009=\u20099,880). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Some comorbidities of PwMS are similarly frequent in other AIDs, while others, such as depression, are more prevalent in PwMS (odds ratio (OR) vs noAID\u2009=\u20092.03(1.94\u20132.13)). We found that personality disorders are more frequently recorded in PwMS before (OR \u2009=\u20091.34(1.21\u20131.49)) and after MS diagnosis (OR \u2009=\u20091.32(1.16\u20131.5)), especially in women (OR \u2009=\u20091.39(1.2\u20131.6)). PwMS are more frequently diagnosed with Lyme disease (OR \u2009=\u20091.98(1.69\u20132.33)), which was predominantly recorded by general practitioners after presentation with neurological symptoms. We observed lower acute tonsillitis frequencies in PwMS (OR \u2009=\u20090.8(0.75\u20130.85)). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Our results suggest that PwMS might have a generally increased risk for specific personality disorders. More frequent Lyme disease recordings for PwMS suggest misdiagnoses of MS symptoms. Lower tonsillitis frequencies suggest a link between MS and protection from specific infections. <\/jats:p><\/jats:sec>","DOI":"10.1177\/20552173251315458","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T10:36:01Z","timestamp":1739356561000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early comorbidities and diagnostic challenges in people with multiple sclerosis with possible impact on disease management"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1711-187X","authenticated-orcid":false,"given":"Christine","family":"Makarov","sequence":"first","affiliation":[{"name":"School of Medicine and Health, Department of Neurology, Technical University of Munich, TUM University Hospital, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0668-0049","authenticated-orcid":false,"given":"Ewan","family":"Donnachie","sequence":"additional","affiliation":[{"name":"Bavarian Association of Statutory Health Insurance Physicians, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6765-6352","authenticated-orcid":false,"given":"Alexander","family":"Hapfelmeier","sequence":"additional","affiliation":[{"name":"School of Medicine and Health, Institute of AI and Informatics in Medicine, Technical University of Munich, TUM University Hospital, Munich, Germany"},{"name":"School of Medicine and Health, Institute of General Practice and Health Services Research, Technical University of Munich, TUM University Hospital, Munich, Germany"},{"name":"Munich Center for Health Economics and Policy, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5985-6784","authenticated-orcid":false,"given":"Bernhard","family":"Hemmer","sequence":"additional","affiliation":[{"name":"School of Medicine and Health, Department of Neurology, Technical University of Munich, TUM University Hospital, Munich, Germany"},{"name":"Munich Cluster for Systems Neurology (SyNergy), Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0524-6005","authenticated-orcid":false,"given":"Christiane","family":"Gasperi","sequence":"additional","affiliation":[{"name":"School of Medicine and Health, Department of Neurology, Technical University of Munich, TUM University Hospital, Munich, 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