Increased mental health care use by mothers of children with multiple sclerosis
Marrie RA, O’Mahony J, Maxwell C, Ling V, Yeh EA, Arnold DL, Bar-Or A, Banwell B; Canadian Pediatric Demyelinating Disease Network. Neurology. 2020; 94(10):e1040-50. Epub 2020 Jan 9. DOI: https://doi.org/10.1212/WNL.0000000000008871
Objective — We compared the prevalence of physical and mental conditions and rate of health care utilization in mothers of children with multiple sclerosis (MS) (MS-mothers) with that of mothers of children without MS (non-MS-mothers).
Methods — Using population-based administrative data from Ontario, Canada, we identified MS-mothers and non-MS-mothers, matched on maternal age at childbirth, region, and the child's age and sex at the time of MS diagnosis. We compared the prevalence of any physical condition or any mood or anxiety disorder between the cohorts, in the child's MS diagnosis year, and 5 years before and after diagnosis. We compared rates of physician visits before diagnosis, during the diagnosis year, and after the child's diagnosis using multivariable regression models with generalized estimating equations adjusting for maternal age, socioeconomic status, region of residence, and index year.
Results — We identified 156 MS-mothers and 624 non-MS-mothers. MS-mothers had a higher prevalence of any physical condition and of any mood or anxiety disorder than non-MS-mothers, before, during, and after their child's diagnosis. On multivariable analysis, MS-mothers did not have higher rates of primary care visits (rate ratio [RR] 1.04; 95% confidence interval [CI] 0.90–1.20), but exhibited increased odds of having any psychiatry visits (odds ratio 1.60; 95% CI 1.10–2.31); the rate of visits did not differ when they did occur (RR 0.66; 95% CI 0.33–1.30).
Conclusion — Mothers of children with MS use more mental health services before and after their child's MS diagnosis than mothers of children without MS. Pediatric health care providers should consider the mental well-being of mothers and their children with MS.