Evidence map›Paper›PMID 34470802›Full record

ArticleNeurology2021

Interface of Multiple Sclerosis, Depression, Vascular Disease, and Mortality: A Population-Based Matched Cohort Study.

Raffaele Palladino, Jeremy Chataway, Azeem Majeed, Ruth Ann Marrie

Abstract readComment
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
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  6. Article
  7. Article
  8. Comorbidity and modifiable risk factors in multiple sclerosis.Therapeutic advances in neurological disorders · 2026
    Review
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  15. Depression and anxiety in multiple sclerosis. Review of a fatal combination.Journal of neural transmission (Vienna, Austria : 1996) · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Raffaele PalladinoFrom the Department of Primary Care and Public Health (R.P., A.M.), Imperial College of London, UK; Department of Public Health (R.P.) and CIRMIS-Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (R.P.), University "Federico II" of Naples, Italy; Queen Square Multiple Sclerosis Centre (J.C.), Department of Neuroinflammation, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Institute for Health Research (J.C.), University College London Hospitals, Biomedical Research Centre, London, UK; and Departments of Medicine (R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. r.palladino@imperial.ac.uk.ORCID 0000-0002-3437-812X
Jeremy ChatawayFrom the Department of Primary Care and Public Health (R.P., A.M.), Imperial College of London, UK; Department of Public Health (R.P.) and CIRMIS-Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (R.P.), University "Federico II" of Naples, Italy; Queen Square Multiple Sclerosis Centre (J.C.), Department of Neuroinflammation, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Institute for Health Research (J.C.), University College London Hospitals, Biomedical Research Centre, London, UK; and Departments of Medicine (R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Azeem MajeedFrom the Department of Primary Care and Public Health (R.P., A.M.), Imperial College of London, UK; Department of Public Health (R.P.) and CIRMIS-Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (R.P.), University "Federico II" of Naples, Italy; Queen Square Multiple Sclerosis Centre (J.C.), Department of Neuroinflammation, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Institute for Health Research (J.C.), University College London Hospitals, Biomedical Research Centre, London, UK; and Departments of Medicine (R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.ORCID 0000-0002-2357-9858
Ruth Ann MarrieFrom the Department of Primary Care and Public Health (R.P., A.M.), Imperial College of London, UK; Department of Public Health (R.P.) and CIRMIS-Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (R.P.), University "Federico II" of Naples, Italy; Queen Square Multiple Sclerosis Centre (J.C.), Department of Neuroinflammation, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Institute for Health Research (J.C.), University College London Hospitals, Biomedical Research Centre, London, UK; and Departments of Medicine (R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesTo assess whether the association among depression, vascular disease, and mortality differs in people with multiple sclerosis (MS) compared with age-, sex-, and general practice-matched controls.

methodsWe conducted a population-based retrospective matched cohort study between January 1, 1987, and September 30, 2018, that included people with MS and matched controls without MS from England, stratified by depression status. We used time-varying Cox proportional hazard regression models to test the association among MS, depression, and time to incident vascular disease and mortality. Analyses were also stratified by sex.

resultsWe identified 12,251 people with MS and 72,572 matched controls. At baseline, 21% of people with MS and 9% of controls had depression. Compared with matched controls without depression, people with MS had an increased risk of incident vascular disease regardless of whether they had comorbid depression. The 10-year hazard of all-cause mortality was 1.75-fold greater in controls with depression (95% confidence interval [CI] 1.59-1.91), 3.88-fold greater in people with MS without depression (95% CI 3.66-4.10), and 5.43-fold greater in people with MS and depression (95% CI 4.88-5.96). Overall, the interaction between MS status and depression was synergistic, with 14% of the observed effect attributable to the interaction. Sex-stratified analyses confirmed differences in hazard ratios. DISCUSSION: Depression is associated with increased risks of incident vascular disease and mortality in people with MS, and the effects of depression and MS on all-cause mortality are synergistic. Further studies should evaluate whether effectively treating depression is associated with a reduced risk of vascular disease and mortality.

Indexed as

Multiple SclerosisVascular DiseasesCohort StudiesDepressionHumansRetrospective Studies

Identifiers

PMID34470802
PMCPMC8480403

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.