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Abstract

Few population-based, methodologically rigorous studies have evaluated the association between mental health and health behaviours in MS. The goal of this dissertation is to contribute to the broader understanding of these relationships and their potential impact on MS. This dissertation was based on two main cohorts: 1) a multi-site clinic-based longitudinal cohort from across Canada; 2) a population-based health administrative and clinical cohort in British Columbia. A large (n=949) sample of MS patients were recruited from four Canadian MS clinics. Participants completed a series of questionnaires at three visits over two years. The prevalence of psychiatric comorbidities (depression [35%] and anxiety [54%]), and adverse health behaviours (smoking [24%] and non-adherence to disease-modifying therapies (DMTs) [22%]) was high. Alcohol dependence was associated with increased odds of anxiety (Odds Ratio (OR):1.84;95% confidence interval (CI):1.32–2.58) and depression (OR:1.53;95%CI:1.05–2.23), as was smoking (anxiety OR:1.29;95% CI:1.02–1.63; depression OR:1.37;95%CI:1.04–1.78). Non-adherence (