Prevalence of bipolar disorder in multiple sclerosis: A systematic review and meta-Analysis

Boney Joseph, Aiswarya L. Nandakumar, Ahmed T. Ahmed, Neethu Gopal, M. Hassan Murad, Mark A. Frye, W. Oliver Tobin, Balwinder Singh

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Multiple sclerosis (MS) is a chronic disabling, demyelinating disease of the central nervous system and is often associated with psychiatric comorbidities. Some studies suggest increased prevalence of bipolar disorder (BD) in MS. Objective: To conduct a systematic review and meta-Analysis assessing the prevalence of BD in adults with MS. Methods: We registered this review with PROSPERO and searched electronic databases (Ovid MEDLINE, Central, Embase, PsycINFO and Scopus) for eligible studies from earliest inception to October 2020. Prevalence data of BD in adult patients with MS were extracted. Meta-Analysis was conducted using random-effects model. Findings: Of the 802 articles that were screened, 23 studies enrolling a total of 68 796 patients were included in the systematic review and meta-Analysis. The pooled prevalence rate of BD in patients with MS was 2.95% (95% CI 2.12% to 4.09%) with higher prevalence in the Americas versus Europe. The lifetime prevalence of BD was 8.4% in patients with MS. Subgroup analysis showed a higher prevalence of BD in MS in females (7.03%) than in males (5.64%), which did not reach statistical significance (p=0.53). Conclusions: This meta-Analysis suggests a high lifetime prevalence of BD in patients with MS. Patients with MS should be routinely screened for BD. Further assessment of bipolar comorbidity in MS through prospective studies may help in developing effective management strategies and may improve treatment outcomes in patients with MS.

Original languageEnglish (US)
Article number300207
JournalEvidence-Based Mental Health
DOIs
StateAccepted/In press - 2020

Keywords

  • adult psychiatry
  • depression & mood disorders

ASJC Scopus subject areas

  • Psychiatry and Mental health

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