Prevalence of Psychiatric Disorders in Patients with Demyelinating Disease in MS Clinic Siriraj Hospital

Abstract

ABSTRACT
Objective: To examine prevalence of psychiatric disorders and their correlated factors in patients with demyelinating disease in MS Clinic, Siriraj Hospital.
Methods: During January - August 2010, One hundred and thirty-six patients with demyelinating disease were interviewed by psychiatrist or psychologist using the M.I.N.I thai version. Patients who were diagnosed as having major depressive episodes were assessed for the severity of depression by using the Hamilton rating scale for depression Thai version. The data was analyzed by descriptive statistics including percentage, mean, standard deviation and statistic correlation of correlated factors of psychiatric disorders using odd ratio with Fisher’s Exact test, continuity correction and Pearson chi-Square.
Results: In one hundred and thirty-six patients with demyelinating disease, there were 110 female patients (80.9%) and the mean age was 42.7 years. Most of them had multiple sclerosis (54.4%). The most common psychiatric disorder was major depressive episode (8.8%). The severity of depression by the Hamilton
rating scale for depression Thai version was 19+5.9 (mean+SD), classified as major depression. Other psychiatric disorders were generalized anxiety disorder (4.4%), alcohol dependence/abuse (4.4%), dysthymia (2.9%), psychotic disorders (2.2%), manic episode (0.7%), panic disorder (0.7%), social phobia (0.7%). Suicidality of patients with demyelinating disease was 16.9% and most was with low risk (73.9%). Statistically significant correlated factors of major depressive episode were ataxia; OR 5.600 (95%CI; 1.432, 21.894, p 0.023) and blurred vision; OR 0.187 (95%CI; 0.039, 0.891, p 0.044). Statistically significant correlated factors for suicidality were no income; OR 3.946 (95%CI; 1.559, 9.987, p 0.006), weakness; OR 4.664 (95%CI; 1.484, 14.655, p 0.01) and major depressive episode;OR 14.533 (95%CI; 3.898, 54.188, p<0.001).
Conclusion: The most common psychiatric disorder in patients with demyelinating disease was major depressive episode. Patients with demyelinating disease who had major depressive episode had
increased suicidal risk.