MONTREAL — Women with multiple sclerosis have a higher risk of perinatal mental illness compared to those with other chronic illnesses, reveals an analysis of nearly 900,000 births in Ontario.
Researchers found that 8% of women with MS developed a new mental illness during pregnancy, a percentage that jumped to 14% during the first year after birth.
“Mental illness during pregnancy or after childbirth can have a great impact on the parent and child, but very little is known about mental illness during pregnancy,” said the author of the paper. study, Dr. Ruth Ann Marrie of the Dalhousie University Faculty of Medicine.
The study compared women with MS to those with other chronic illnesses such as epilepsy, inflammatory bowel disease and diabetes, as well as healthy women.
The incidence of mental illness was 26% higher during pregnancy among women with MS, while the risk was 33% higher during the first year after giving birth, even after taking into account factors such as age, socio-economic status and obstetric complications.
In total, mental illness affected 42% of people with MS during pregnancy and 50% during the first year postpartum, compared to 30% and 38% for women without MS.
About 1% of people with MS have experienced psychosis, and almost 6% have developed substance use disorders in the year after giving birth.
People with epilepsy, inflammatory bowel disease and diabetes also had an increased risk of mental illness during pregnancy and the first postnatal year, compared to people without these conditions.
These findings are consistent with the overall higher incidence of mental illness among people with multiple sclerosis, Dr. Marrie said.
-“And we’re not just talking about a single mental illness,” she clarified. The risk of depression was higher, the risk of psychosis was higher, the risk of anxiety, the risk associated with suicide…”
Part of the association between MS and mental illness is genetic, Dr. Marrie said. We also know that “adverse life experiences” ― such as physical or emotional abuse, or even neglect ― can increase both the risk of MS and the risk of mental illness.
Certain brain injuries may also increase the risk of MS and mental illness, Dr. Marrie said, but there is still much to learn about the association between the two.
“So there may be common risk factors,” she said. So, if we think about someone who has to deal with a chronic illness, and who also has to deal with everything that comes with pregnancy, adapting to stress and emotional and physical and hormonal changes… all of that can contribute to increased risk (of mental illness) during pregnancy, but that’s just a theory.”
The important thing right now, Dr. Marrie concluded, is to realize that mental illness during pregnancy is more common than we think. At the clinical level, when faced with a patient with MS who is pregnant or planning to be pregnant, “it would be a good time to talk to her about things she needs to know.”
“We must ensure that these patients have the right support and that they know where to turn if symptoms appear,” she said. We need to ask these patients questions if we want to be able to intervene in a timely manner.”
The findings of this study were published by the medical journal Neurology.
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