Psychiatric Drug Consumption Among Multiple Sclerosis Patients Before and After Disability Pension; a Controlled Register Study

Abstract

Introduction Many multiple sclerosis (MS) patients suffer from psychiatric comorbidity, and 60% of patients of working age are on disability pension (DP). It is unknown how transition to DP affects MS patients’ mental health. Objectives To investigate the risk for being prescribed psychiatric drugs before and after receiving full-time DP in MS patients compared to matched controls. Aims To examine the impact of transition of DP on MS patients' mental health. Methods Nationwide Swedish registers were used to identify all 3836 MS patients who were granted full-time DP in 2000-2012, along with 19,180 propensity matched controls also being granted DP in the same years. Patients and controls were organized into cohorts by year of DP, and adjusted odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated for being prescribed Selective Serotonine Reuptake Inhibitors (SSRIs), benzodiazepines and sleeping agents in 2006. Results The risk for being prescribed psychiatric drugs increased in the years leading up to DP among both MS patients and controls. After DP, the risk for benzodiazepines increased among MS patients but was unchanged among controls (OR 1.72, 95%CI 1.16-2.57). MS patients had an increased risk for SSRIs after DP compared to controls (OR 1.76, 95%CI 1.44-2.15). Conclusions The risk for being prescribed psychiatric drugs after DP differs substantially between MS patients and other DP diagnoses. Possible reasons for the increased psychiatric illness among MS patients during and after transition to DP should be further investigated, as well as the role of DP as a rehabilitory measure.