Multivariate Model of Bipolar Disorder Predictors in Multiple Sclerosis: a Longitudinal Study

Background: risk of bipolar disorder (BD) development in people with multiple sclerosis (MS) is much higher than in general population. However, there is a lack of studies developing the role of predictors of BD in patients with MS. Objective: to study sociodemographic, clinicopsychopathological and clinicofunctional characteristics significant to predict the development of BD in MS. Patients and Methods: 750 patients with MS were examined, 25 of them were diagnosed as bipolar disorder. The control group consisted of 25 MS patients without any mental disorder. The observation period was 10 years. The following scales were used: Beck Depression Inventory (BDI), Multidimensional Fatigue Inventory (MFI-20), Spielberger State-Trait Anxiety Inventory (STAI), visual analogue scale (VAS) for assessing pain, Paced Auditory Serial Addition Test (PASAT), Expanded Disability Status Scale (EDSS). Also, we identified significant stressful events. The diagnosis of BD was stated according to ICD-10 criteria. Multivariate models were developed using analysis of variance and multiple linear regression equation. Results: a multifactorial model of predictors of the development of BD with a high multiple correlation value (r = 0.80) was proposed. Factors with pronounced influence on the development of BD were: high rate of progression of MS, highly active course of MS, asthenia — 58.2.6 ± 2.6 points on the MFI-20 scale with an increase of 4.2%/year, localization of lesions in the periventricular white matter and in the left hemisphere cerebellum. Significant factors were: multiple lesions by the onset of MS, reactive anxiety — 56.62 ± 2.34 points on the Spielberger-Khanin scale with an increase of 2.43% per year, cognitive impairment with an increase of 4,97% per year; increase in the area of lesions in the brain by 1.67% per year. Age of onset of MS, age of onset of bipolar disorder, disability indicator according to EDSS, type of MS, disease-modifying drugs for MS use have not shown the significant influence on the development of BD in MS. Conclusion: the proposed model of predictors of the BD development in patients with MS can be used to predict the development of bipolar disorder and to provide personalized medical care.

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