Racial identity, marginalization, and depression in pediatric-onset multiple sclerosis.

BACKGROUND

Individuals with pediatric-onset multiple sclerosis (POMS) experience higher levels of depressive symptoms compared with those with monophasic acquired demyelinating syndromes (mono-ADSs). Associations among racial identity, marginalization, and depression have not been investigated in these populations.

OBJECTIVES

To determine the relationship among racial identity, neighborhood marginalization, and depression in POMS compared with mono-ADS.

METHODS

Secondary analysis of the Center for Epidemiologic Studies Depression Scale (CES-DC) and racial identity data linked to Canadian Marginalization Index scores for individuals with POMS and mono-ADS recruited from The Hospital for Sick Children. Descriptive and inferential analyses were conducted.

RESULTS

In POMS (n = 100, female = 65), being racialized was associated with elevated depressive symptoms in POMS (relative risk (RR) = 1.50, 95% confidence interval (CI) = 1.04, 2.15) but not in mono-ADS (RR = 0.83, 95% CI = 0.55, 1.26). Black individuals (n = 11) with POMS had higher odds of living in a neighborhood with the highest quintile of marginalization for material resources (OR = 12.7, 95% CI = 1.96, 82.1) compared with White individuals. Higher depression scores are associated with lower household and dwellings scores (rs = -0.27, 95% CI = -0.52, -0.017) in racialized POMS.

CONCLUSION

Racialized identity is associated with elevated depressive symptoms in POMS but not mono-ADS. Racial identity and neighborhood marginalization may influence depression in POMS. Longitudinal studies are needed to verify the direction of these relationships.