{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:18:59Z","timestamp":1791497939560,"version":"4.3.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Persons with multiple sclerosis (pwMS) are often diagnosed with major depressive disorder (MDD). However, there is a paucity of knowledge regarding the association between different demographic features and such co-diagnosis, as well as the clinical implications the co-diagnosis may carry. This study investigated whether specific demographics demonstrated any correlation with co-diagnosis of MS and MDD, and how MDD comorbidity may potentially impact clinical outcomes. In this single-center study, Black pwMS were more likely to have a MDD comorbidity, and Hispanic pwMS were less likely. MDD comorbidity in pwMS was associated with significantly increased time to disease-modifying therapy (DMT), with the greatest increase in time associated with individuals who received the MDD diagnosis after the MS diagnosis. Among inpatient pwMS, individuals with MDD comorbidity were associated with a decreased usage of MRI while hospitalized. Those who received MDD diagnosis prior to MS were associated with an even further decreased usage of inpatient MRI, and greater mortality. These findings suggest that patient demographics play an important role in how clinicians diagnose MDD in patients with MS. Furthermore, co-diagnosis of MDD may be an important variable that affects healthcare resource utilization and health outcomes.<\/jats:p>","DOI":"10.3389\/fneur.2025.1663778","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T14:37:04Z","timestamp":1757947024000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Major depressive disorder in multiple sclerosis associated with differences in disease modifying therapy and demographics"],"prefix":"10.3389","volume":"16","author":[{"given":"Nathanael J.","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Hui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. William","family":"Pike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Galetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas B.","family":"Kipp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scheherazade","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Sai","family":"Folmsbee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1073278","DOI":"10.3389\/fpubh.2023.1073278","article-title":"Global, regional, and national burden of multiple sclerosis from 1990 to 2019: findings of global burden of disease study 2019","volume":"11","author":"Qian","year":"2023","journal-title":"Front Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"105895","DOI":"10.1016\/j.msard.2024.105895","article-title":"Depression and sedentary behaviour in women with multiple sclerosis","volume":"91","author":"Machado","year":"2024","journal-title":"Mult Scler Relat Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jns.2016.11.067","article-title":"Prevalence of depression and anxiety in multiple sclerosis: a systematic review and meta-analysis","volume":"372","author":"Boeschoten","year":"2017","journal-title":"J Neurol Sci"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1001\/jamaneurol.2024.2920","article-title":"Comorbidity and disease activity in multiple sclerosis","volume":"81","author":"Salter","year":"2024","journal-title":"JAMA Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1212\/WNL.59.5.662","article-title":"Multiple sclerosis, depression, and the risk of suicide","volume":"59","author":"Caine","year":"2002","journal-title":"Neurology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1177\/1352458511417835","article-title":"Multiple sclerosis and depression","volume":"17","author":"Feinstein","year":"2011","journal-title":"Mult Scler"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"106158","DOI":"10.1016\/j.msard.2024.106158","article-title":"Improvement in depressive symptoms is associated with sustained improvement in fatigue impact in adults with multiple sclerosis","volume":"92","author":"Knowles","year":"2024","journal-title":"Mult Scler Relat Disord"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e0312486","DOI":"10.1371\/journal.pone.0312486","article-title":"Factors associated with low health-related quality of life in persons with multiple sclerosis: a quantile-based segmentation approach","volume":"19","author":"Iaquinto","year":"2024","journal-title":"PLoS One"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"105943","DOI":"10.1016\/j.msard.2024.105943","article-title":"Comorbidities and their association with outcomes in the multiple sclerosis population: a rapid review","volume":"92","author":"Frank","year":"2024","journal-title":"Mult Scler Relat Disord"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1023\/A:1023884322540","article-title":"In search of a conceptualization of multiple sclerosis: a historical perspective","volume":"13","author":"Butler","year":"2003","journal-title":"Neuropsychol Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e2026","DOI":"10.1212\/WNL.0000000000207843","article-title":"Psychiatric comorbidity during the prodromal period in patients with multiple sclerosis","volume":"101","author":"Chertcoff","year":"2023","journal-title":"Neurology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1177\/1352458515622826","article-title":"Characterizing the phenotype of multiple sclerosis-associated depression in comparison with idiopathic major depression","volume":"22","author":"Hasselmann","year":"2016","journal-title":"Mult Scler"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1177\/13524585231189673","article-title":"Assessing heterogeneity of treatment effect in multiple sclerosis trials","volume":"29","author":"Sormani","year":"2023","journal-title":"Mult Scler"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1002\/1531-8249(200006)47:6<707::AID-ANA3>3.0.CO;2-Q","article-title":"Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination","volume":"47","author":"Lucchinetti","year":"2000","journal-title":"Ann Neurol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"a028928","DOI":"10.1101\/cshperspect.a028928","article-title":"Clinical course of multiple sclerosis","volume":"8","author":"Klineova","year":"2018","journal-title":"Cold Spring Harb Perspect Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3147","DOI":"10.1093\/brain\/awac016","article-title":"How patients with multiple sclerosis acquire disability","volume":"145","author":"Lublin","year":"2022","journal-title":"Brain"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1038\/s41572-018-0041-4","article-title":"Multiple sclerosis","volume":"4","author":"Filippi","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1016\/j.msard.2016.07.003","article-title":"Brain health: time matters in multiple sclerosis","volume":"9","author":"Giovannoni","year":"2016","journal-title":"Mult Scler Relat Disord"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"5382","DOI":"10.1007\/s00415-022-11193-w","article-title":"Early use of high-efficacy disease-modifying therapies makes the difference in people with multiple sclerosis: an expert opinion","volume":"269","author":"Filippi","year":"2022","journal-title":"J Neurol"},{"key":"ref21","first-page":"s321","article-title":"Impact of diagnosis and early treatment on the course of multiple sclerosis","volume":"19","author":"Noyes","year":"2013","journal-title":"Am J Manag Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1038\/s41582-022-00704-y","article-title":"Towards a global view of multiple sclerosis genetics","volume":"18","author":"Jacobs","year":"2022","journal-title":"Nat Rev Neurol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"123260","DOI":"10.1016\/j.jns.2024.123260","article-title":"The intersection of race and sex on the clinical and cognitive progression of multiple sclerosis","volume":"466","author":"Moody","year":"2024","journal-title":"J Neurol Sci"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1212\/CPJ.0000000000001105","article-title":"How multiple sclerosis symptoms vary by age, sex, and race\/ethnicity","volume":"11","author":"Kister","year":"2021","journal-title":"Neurol Clin Pract"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"147","DOI":"10.3390\/psychiatryint4020017","article-title":"The association between social determinants of health and depressive disorders: a 2017 behavioral risk factor surveillance system (BRFSS) analysis","volume":"4","author":"Wilkinson","year":"2023","journal-title":"Psychiatry Int"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1002\/wps.21160","article-title":"The social determinants of mental health and disorder: evidence, prevention and recommendations","volume":"23","author":"Kirkbride","year":"2024","journal-title":"World Psychiatry"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.jocn.2024.04.021","article-title":"Antipsychotic medications associated with increased length of hospital stay in autoimmune encephalitis and multiple sclerosis: a retrospective study","volume":"124","author":"Sai Folmsbee","year":"2024","journal-title":"J Clin Neurosci"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"104914","DOI":"10.1016\/j.msard.2023.104914","article-title":"Stress indicators in minorities with multiple sclerosis","volume":"78","author":"Hunter","year":"2023","journal-title":"Mult Scler Relat Disord"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"101398","DOI":"10.1016\/j.dhjo.2022.101398","article-title":"Physical activity as a correlate of symptoms, quality of life, comorbidity, and disability status in Hispanics with multiple sclerosis \u2013 PubMed","volume":"16","author":"Silveira","year":"2022","journal-title":"Disabil Health J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1080\/1536710X.2011.622959","article-title":"A pilot study of Latinos with multiple sclerosis: demographic, disease, mental health, and psychosocial characteristics","volume":"10","author":"Buchanan","year":"2011","journal-title":"J Soc Work Disabil Rehabil"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12916-018-1246-9","article-title":"Challenges and opportunities in examining and addressing intersectional stigma and health","volume":"17","author":"Turan","year":"2019","journal-title":"BMC Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1590\/1516-4446-2015-1652","article-title":"Stigma toward mental illness in Latin America and the Caribbean: a systematic review","volume":"38","author":"Mascayano","year":"2016","journal-title":"Braz J Psychiatry"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1093\/ije\/dyu039","article-title":"Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing \u2018what matters most\u2019 to identify culture-specific aspects of stigma","volume":"43","author":"Yang","year":"2014","journal-title":"Int J Epidemiol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jad.2018.08.011","article-title":"Depression and chronic diseases: co-occurrence and communality of risk factors","volume":"241","author":"Lotfaliany","year":"2018","journal-title":"J Affect Disord"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1663778\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T14:37:05Z","timestamp":1757947025000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1663778\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":34,"alternative-id":["10.3389\/fneur.2025.1663778"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1663778","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]},"article-number":"1663778"}}