الفهرس | Only 14 pages are availabe for public view |
Abstract Multiple sclerosis (MS) is a chronic, progressively disabling disease of the CNS, estimated to affect millions of people worldwide. Comorbidities are a common issue in MS. They refer to the total burden of illness other than the specific disease of interest. All types of disorders including; physical, psychiatric and autoimmune, could be present as comorbidity with MS. They affect many patients and carry many adverse health outcomes, including reduced functional status, increased use of health-care services, reduced quality of life, and increased mortality. The aim of this study is to assess comorbidities prevalences and risks amongst patients with multiple sclerosis, and its relation to disability. This study was carried out on 30 patients having multiple sclerosis, collected from patients attending Menofiya and Mansoura university hospitals. The study also enrolled 30 of healthy subjects as control group. Comorbidities were divided into 4 groups; physical, psychiatric, immunological and multiple disorders. Patients were diagnosed according to McDonald criteria (2010 revision). All the subjects have been evaluated by clinical history and examination, Structured Clinical Interview for DSM disorders (SCID) to detect psychiatric comorbidities, rheumatology work up to detect autoimmune disorders, the Kurtzke Expanded Disability Status Scale (EDSS) for disability assessment, and MRI brain and/or spinal cord. The results included the following: As expected, female patients represented the majority of the sample, and the majority of patients fall in age group 30-40 years. Relapsing remitting course was more prevalent, and it was associated with more affection of physical and psychiatric comorbidities. The main presentations of the illness were visual affection, bladder dysfunction and pyramidal affection. Nearly, one third of the patients had EDSS greater than 4, and this was associated with more affection with comorbidities. All patients had periventricular patches in MRI brain. Comorbidities affected the majority of MS patients, while nearly one fifth was affected with multiple comorbidities. This result was statistically significant. With increasing number of relapses, comorbidities increase. This result was statistically significant MS patients suffer from various types of comorbidities compared to controls. Arthritis, hypertension, headache and depression were among the most prevalent comorbidities. Moreover, comorbidities were significantly related to age and sex, the majority of MS female participants had comorbidities, and nearly all patients above 40 years were affected with comorbidities. |