Multiple sclerosis relapses and depression

Moore, Pascale; Hirst, Claire Louise; Harding, Katharine; Clarkson, Hannah; Pickersgill, Trevor; Robertson, Neil

doi:10.1016/j.jpsychores.2012.08.004

Cited by 66 publications

(38 citation statements)

References 29 publications

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“…Depression symptoms increase during a relapse, however they do not typically resolve following recovery but may become persistent [46]. Depression can also exacerbate or be implicated in other symptoms of MS including fatigue (2), cognitive processing and working memory [47,48], as well as the experience of pain symptoms (4).…”

Section: Discussionmentioning

confidence: 99%

Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

et al. 2014

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Background: Depression is the most common co-morbidity for people with Multiple Sclerosis (MS); irrespective of disease severity, depression has the greatest impact on quality of life. An emerging paradigm in the treatment of depression is lifestyle medicine. There is significant potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. This study sought to understand the association between lifestyle risk factors, medication and depression risk through the analysis of self-reported data from a large international sample of people with MS. Methods: This cross-sectional analysis recruited a total of 2459 participants via Web 2.0 platforms. Survey data included socio-demographics; a range of lifestyle risk factors; medication; disease variables and depression risk using the Patient Health Questionnaire-2 (PHQ-2). Results: In total approximately one fifth (19.3%) of our sample screened positive for depression (PHQ-2 score ≥3). Several demographic factors were significantly associated with this depression risk in bivariate analysis. Regression analyses showed that poor diet, low levels of exercise, obesity, smoking, marked social isolation and taking interferon were associated with greater depression risk. Participants who supplemented with omega 3s, particularly flaxseed oil, had frequent fish consumption, supplemented with vitamin D, meditated, and had moderate alcohol consumption had significantly reduced depression risk. Conclusions: This study demonstrates a significant association between modifiable lifestyle factors and depression risk. Planned longitudinal follow up may clarify causality. Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.

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Section: Discussionmentioning

confidence: 99%

Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

et al. 2014

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“…19 Depression seems to be more common early in the disease course 20 and is associated with relapses. 21 In secondary progressive MS patients, feelings of hopelessness become more common.…”

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confidence: 99%

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Brenner

Piehl

2016

Acta Neurol Scand

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Multiple sclerosis (MS) is a neuroinflammatory condition with a prominent progressive neurodegenerative facet that typically affects young-or middle-aged adults. Although physical disabilities have been in the foreground by being easier to assess, there is an increasing interest in mental disabilities and psychiatric co-morbidities, which have a disproportionally high impact on important outcome measures such as quality of life and occupational disability. In particular, cognitive impairment, depression and mental fatigue, which mutually interact with each other, seem to be of importance in this context. In recent decades, major efforts have been invested in developing more effective disease modulatory treatments. This has resulted in novel therapeutic options and awareness of the importance of early intervention. In comparison, good quality and adequately powered studies on symptomatic treatments of fatigue and psychiatric co-morbidities in MS are rare, and awareness of treatment options is much lower. We here review the existing evidence base for symptomatic treatment of fatigue and depression in MS patients. With regard to fatigue, off-label prescription of alertness improving drugs is common, in spite of all but absent evidence of efficacy. In contrast, a number of smaller studies suggest that physical exercise and fatigue management courses may have some clinical benefit. Very few studies have addressed the efficacy of antidepressants and non-pharmaceutical interventions specifically in MS patients. Therefore, treatment guidelines largely rely on data from non-MS populations. In the future, there is a strong motive to direct additional resources to the study of these important aspects of MS. K E Y W O R D Scognitive symptoms, depression, fatigue, multiple sclerosis, treatment

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“…Bu depresif belirtilerdeki artı-şın özellikle engellilik ile ilişkisi olduğu ve bu belirtilerin hastanın eğitim seviyesinden, sosyal desteğinden ve baş etme yöntemlerinden etkilendiği bildirilmiştir. 12 Etiyolojik etkenler olarak hem biyolojik hem de psikososyal faktörlerin önemi vurgulanmıştır. 13 Yapılan çalışmalarda, engelliliğin ve psikososyal stres varlığının psikiyatrik hastalıklara zemin yarattığı ve özellikle de depresyonla güçlü korelasyon gösterdiği saptanmıştır.…”

Section: Multi̇pl Skleroz Ve Majör Depresi̇f Bozuklukunclassified