Stressful life events precede exacerbations of multiple sclerosis.
OBJECTIVE
We longitudinally monitored life events and health changes in patients with multiple sclerosis (MS) to determine whether stressful events may trigger exacerbation of MS.


METHODS
Twenty-three women with MS were followed for 1 year. Each subject completed the Psychiatric Epidemiologic Research Interview on a weekly basis. Further information on potentially stressful events was acquired using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored on a weekly basis throughout the year. Potential MS exacerbations were confirmed by a neurologist who was blind to the presence and timing of stressors.


RESULTS
Eighty-five percent of MS exacerbations were associated with stressful life events in the preceding 6 weeks. Stressful life events occurred an average of 14 days before MS exacerbations, compared with 33 days before a randomly selected control date (p < .0001). Survival analysis confirmed that an increase in frequency of life events was associated with greater likelihood of MS exacerbations (hazard ratio = 13.18, p < .05).


CONCLUSIONS
These results are consistent with the hypothesis that stress is a potential trigger of disease activity in patients with relapsing-remitting MS.
Ackerman
Kurt D
KD
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. ackermankd@msx.upmc.edu
Heyman
Rock
R
Rabin
Bruce S
BS
Anderson
Barbara P
BP
Houck
Patricia R
PR
Frank
Ellen
E
Baum
Andrew
A
D000328:Adult; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors