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 ( r s = −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.