Sage Journals: Discover world-class research

Abstract

Multiple sclerosis (MS) patients are known to be at increased risk from mood disorders and suicidal ideation. A lthough these are often associated with alcohol disorders, the drinking habits of MS patients have not been well studied to date. O ur study assessed drinking patterns in 140 MS patients, focusing on a possible link between problem drinking and mood and anxiety disorders. Lifetime psychiatric diagnoses were ascertained using the Structured C linical Interview for DSM-IV disorders (SCID-IV). Results demonstrate that one in six MS patients drink to excess over the course of their lifetime. Those with a history of problem drinking display a higher lifetime prevalence of anxiety (P =0.006), but not mood disorders. There were also significant associations between problem drinking and a lifetime prevalence of suicidal ideation (P =0.006), substance abuse (P =0.001), and a family history of mental illness (P =0.008). C linicians should be aware of the possibility of problem drinking in MS patients, and how this may complicate the course of their disease. C lues to problem drinking in MS patients are the presence of a positive family history of mental illness and prominent anxiety.

Keywords

alcohol anxiety comorbidity depression multiple sclerosis suicidal ideation

Get full access to this article

View all access options for this article.

References

Minden SL , Schiffer RB. Affective disorders in multiple sclerosis. Review and recommendations for clinical research . Arch Neurol 1990; 47: 98-104 .

Schubert DS , Foliart RH. Increased depression in multiple sclerosis patients: a meta-analysis . Psychosomatics 1993; 34: 124-130 .

Minden SL , Orav J , Reich P. Depression in multiple sclerosis . Gen Hosp Psychiatry 1987; 9: 426-434 .

Schiffer RB , Wineman M , Weitkamp LR. Association between bipolar affective disorder and multiple sclerosis . Am J Psychiatry 1986; 143: 94-95 .

Joffe RT , Lippert GP , Gray TA , Sawa G , Horvath Z. Mood disorder and multiple sclerosis . Arch Neurol 1987; 44: 376-378 .

Kessler RC , McGonagle KA , Zhao S , Nelson CB , Hughes M , Eshleman S , et al. Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States . Arch Gen Psychiatry 1994; 51: 8-19 .

Feinstein A. An examination of suicidal intent in patients with multiple sclerosis . Neurology 2002; 59: 674-678 .

Kessler RC , Crum RM , Warner LA , Nelson CB , Schulenberg J , Anthony JC. Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey . Arch Gen Psychiatry 1997; 54: 313-321 .

Regier DA , Farmer ME , Rae DS , Locke BZ , Keith SJ , Judd LL , et al. Comorbidity of mental disorders with alcohol and other drug abuse . JAMA 1990; 264: 2511-2518 .

10.

Hasin DS , Grant BF. Major depression in 6050 former drinkers: association with past alcohol dependence . Arch Gen Psychiatry 2002; 59: 794-800 .

11.

Merikangas KR , Mehta RL , Molnar BE , Walters EE , Swendsen JD , Aguilar-Gaziola S , et al. Comorbidity of substance use disorders with mood and anxiety disorders: results of the international consortium in psychiatric epidemiology . Addict Behav 1998; 23: 893-907 .

12.

Goodin DS , the Northern California MS Study Group . Survey of multiple sclerosis in Northern California . Mult Scler 1999; 5: 78-88 .

13.

Bondy SJ , Rehm J , Ashley MJ , Walsh G , Single E , Room R. Low-risk drinking guidelines: the scientific evidence . Can J Pub Health 1999; 90: 264-270 .

14.

US Department of Health and Human Services . A comprehensive discussion of the major biomedical and socioeconomic problems of alcoholism and alcohol abuse. In Ninth special report to the US congress on alcohol and health. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism , 1996.

15.

Poser CM , Paty DW , Scheinberg L , McDonald WI , Davis FA , Ebers GC et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol 1983; 13: 227-231 .

16.

Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale . Neurology 1983; 33: 1444-1452 .

17.

First MB , Spitzer RL , Gibbon M , Williams JBW. Structured clinical interview for axis 1 DSM-IV disorders, Patient Edition (SCID-I/P, version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute , 1994.

18.

Beck AT , Steer RA , Ranieri WF. Scale for suicide ideation: psychometric properties of a self-report version . J Clin Psychol 1988; 44: 499-505 .

19.

Jenkins R , Mann AH , Belsey E. Design and use of a short interview to assess social stress and support in research and clinical settings . Soc Sci Med 1981; 151: 195-203 .

20.

Rao SM , Leo HJ , Bernardin L , Unverzagt F. Cognitive dysfunction in multiple sclerosis. 1. Frequency, patterns and prediction . Neurology 1991; 41: 685-691 .

21.

Ross HE. DSM-III-R alcohol abuse and dependence and psychiatric comorbidity in Ontario: results from the mental health supplement to the Ontario health survey . Drug Alcohol Depend 1995; 39: 111-128 .

22.

King M. Alcohol abuse in Huntington’s disease . Psychol Med 1985; 15: 815-819 .

23.

Kolakowsky-Hayner SA , Gourley EV , Kreutzer JS , Marwitz JH , Meade MA , Cifu DX. Post-injury substance abuse among persons with brain injury and persons with spinal cord injury . Brain Injury 2002; 16: 583-592 .

24.

Feinstein A. Multiple sclerosis, depression and suicide . BMJ 1997; 315: 691-692 .

25.

Stenager EN , Stenager E , Koch-Henrikson N , Bronnum-Hansen H , Hyllested K , Jensen K , et al. Suicide and multiple sclerosis: an epidemiological investigation . J Neurol Neurosurg Psychiatry 1992; 55: 542-545 .

26.

Sadovnik AD , Eisen RN , Ebers GC , Paty DW. Cause of death in patients attending multiple sclerosis clinics . Neurology 1991; 41: 1193-1196 .

27.

Beck AT , Steer RA , Trexler LD. Alcohol abuse and eventual suicide: a 5- to 10-year prospective study of alcohol-abusing suicide attempters . J Stud Alcohol 1989; 50: 202-209 .

28.

Rossow I , Romelsjo A , Leifman H. Alcohol abuse and suicidal behavior in young and middle aged men: differentiating between attempted and completed suicide . Addiction 1999; 94: 1199-1207 .

29.

Rao SM , Leo HJ , Bernardin L , Unverzagt F. Cognitive dysfunction in multiple sclerosis. 1. Frequency, patterns and prediction . Neurology 1991; 41: 685-691 .

30.

Morgan HG and Stanton R. Suicide among psychiatric in-patients in a changing clinical scene: suicidal ideation as a paramount index of short-term risk . Br J Psychiatry 1997; 171: 561-563 .

31.

Kessler RC , Borges G , Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey . Arch Gen Psychiatry 1999; 56: 617-626 .

Multiple sclerosis and alcohol: a study of problem drinking

Abstract

Keywords

Get full access to this article

References