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Association of multiple sclerosis with psychiatric disorders and homelessness among veterans in the United States Department of Veterans Affairs healthcare system

Published online by Cambridge University Press:  22 November 2024

Stephanie L. Silveira Open the ORCID record for Stephanie L. Silveira [Opens in a new window] ,
Hind Beydoun  and
Jack Tsai Open the ORCID record for Jack Tsai [Opens in a new window]
Stephanie L. Silveira
Affiliation:
Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
Hind Beydoun
Affiliation:
Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA National Center on Homelessness among Veterans, U.S. Department of Veterans Affairs, Homeless Programs Office, Washington, DC, 20420, USA
Jack Tsai*
Affiliation:
Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA National Center on Homelessness among Veterans, U.S. Department of Veterans Affairs, Homeless Programs Office, Washington, DC, 20420, USA
*
Corresponding author: Jack Tsai; Email: [email protected]
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Abstract

Objective

To describe and compare the prevalence of psychosocial and psychiatric disorders among veterans with multiple sclerosis (MS) and a propensity-score-matched group of veterans without MS, and to identify sociodemographic and clinical characteristics associated with comorbid psychosocial and psychiatric problems among veterans with MS.

Methods

Data were linked and extracted from the Veterans Affairs (VA) Homeless Operations Management and Evaluation System and the Corporate Data Warehouse. The total sample comprised 27,342 veterans in the VA healthcare system between January 1, 2022, and June 30, 2023, who met eligibility criteria for an MS diagnosis (n=13,671) and 1:1 propensity-score-matched sample of veterans who did not have MS (n=13,671). MS diagnosis, substance use disorder (SUD), mental illness, and homelessness were defined using standard ICD-10 codes. Covariates included sex, age, Charlson Comorbidity Index (CCI), and VA service-connected disability rating.

Results

A higher prevalence of mental illness among veterans with MS (33%) was found compared with those without MS (31%). Multivariable logistic regression models indicated MS was negatively associated with diagnoses of alcohol use disorder, stimulant use disorders, posttraumatic stress disorder, and schizophrenia/schizoaffective disorder but positively associated with diagnoses of cannabis use disorder and major depressive disorder. MS was not significantly related to homelessness. Disparities in psychosocial and psychiatric disorders among veterans with MS are described.

Conclusion

This study provides novel insights regarding rates of homelessness, SUD, and mental illnesses among veterans with MS. Interdisciplinary approaches to identification and management of mental illness, SUD, and homelessness among veterans with MS are critically needed.

Keywords

mental healthsubstance usehomelessnessmultiple sclerosisveteran
Type
Original Research
Information
CNS Spectrums , Volume 29 , Issue 5 , October 2024 , pp. 433 - 440
Creative Commons
This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press.
Copyright
© U.S. Department of Veterans Affairs, 2024.

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