Background: Pediatric multiple sclerosis (MS) may hamper educational achievements due to psychiatric comorbidity and cognitive impairment. Our aims were to investigate school performance, psychiatric comorbidity, and healthcare utilization following pediatric MS and to differentiate between disability in MS and that arising from a non-brain-related chronic disease. Methods: We included all children (<18 years) with MS onset during 2008–2015 in Denmark with a medical record–validated MS diagnosis. The control groups were children from the general population or children with non-brain-related chronic diseases. Outcomes were register-based on 9–12 grade point average, psychiatric comorbidity, and healthcare visits. Results: Cohorts were children with MS (n = 92), control children matched to children with MS (n = 920), children with non-brain-related chronic diseases (n = 9108), and “healthy” children with neither MS nor brain-related chronic disease (n = 811,464). School performance in grades 9–12 was similar, but children with MS compared to those with non-brain-related chronic disease had an almost doubled hazard for psychiatric comorbidity (hazard ratio = 1.87; 95% confidence interval = 1.38–2.53; p < 0.0001) and a higher rate of all hospital visits (p < 0.0001) but a lower rate of hospital admissions (p = 0.001). Conclusion: Children with MS have a seemingly standard school performance but increased psychiatric comorbidity and a high rate of healthcare utilization.

中文翻译：

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儿童多发性硬化症的学校表现、精神病合并症和医疗保健利用：一项全国性的基于人群的观察性研究

背景：小儿多发性硬化症 (MS) 可能会因精神疾病和认知障碍而妨碍教育成就。我们的目标是调查儿童 MS 后的学校表现、精神疾病合并症和医疗保健利用，并区分 MS 的残疾和非脑相关慢性疾病引起的残疾。方法：我们纳入了 2008 年至 2015 年在丹麦的所有 MS 发病儿童（<18 岁），其医疗记录证实了 MS 诊断。对照组为一般人群的儿童或患有非脑相关慢性疾病的儿童。结果是基于 9-12 的平均成绩点、精神病合并症和医疗保健就诊登记的。结果：队列为 MS 儿童 (n = 92)，与 MS 儿童匹配的对照儿童 (n = 920)，患有非脑相关慢性疾病的儿童 (n = 9108) 和既没有 MS 也没有脑相关慢性疾病的“健康”儿童 (n = 811,464)。9-12 年级的学校表现相似，但与非脑相关慢性病患者相比，MS 儿童患精神疾病的风险几乎翻倍（风险比 = 1.87；95% 置信区间 = 1.38-2.53；p < 0.0001）和较高的所有住院率（p < 0.0001），但住院率较低（p = 0.001）。结论：MS 儿童的学校表现看似标准，但精神疾病合并症增加，医疗保健利用率高。但与患有非脑相关慢性疾病的儿童相比，患有 MS 的儿童患精神疾病的风险几乎翻了一番（风险比 = 1.87；95% 置信区间 = 1.38-2.53；p < 0.0001），并且所有就诊率都更高(p < 0.0001) 但住院率较低 (p = 0.001)。结论：MS 儿童的学校表现看似标准，但精神疾病合并症增加，医疗保健利用率高。但与患有非脑相关慢性疾病的儿童相比，患有 MS 的儿童患精神疾病的风险几乎翻了一番（风险比 = 1.87；95% 置信区间 = 1.38-2.53；p < 0.0001），并且所有就诊率都更高(p < 0.0001) 但住院率较低 (p = 0.001)。结论：MS 儿童的学校表现看似标准，但精神疾病合并症增加，医疗保健利用率高。