Association of acute stress with multiple sclerosis onset and relapse in Saudi Arabia

Abstract

Objectives: To determine if there is a relationship between acute stress and either the onset or relapse of multiple sclerosis (MS) and to discover how different types of acute stressors may be involved. Methods: This study was carried out in Saudi Arabia between September 2017 and June 2018 and involved King Fahad University Hospital in Eastern province, Arfa Multiple Sclerosis Society in the Central and Western province of Saudi Arabia. A cross-sectional descriptive study was performed using an Arabic self-constructed questionnaire consisted of 4 sections: 1) demographic data and time of diagnosis; 2) emotional/psychological stressors; 3) environmental/physical stressors; and 4) 4 specific stressors measuring their effect on the severity and recurrence of attacks. Results: A total of 370 patients participated in the study. Almost half of patients reported no effect of family problems on their disease, whereas the other reported that family problems have an impact on the onset or relapse of the disease. Majority of patients reported that work and social life stressors affect the recurrence of attacks. Cold weather showed no effect on MS; however, hot weather and physical activity increased the number of attacks. Continuous thinking about social stress and problems, mood swings, and sleep deprivation showed an impact on the severity and recurrence of attacks. Financial problems showed no effect. Conclusion: Study indicates that an association exists between acute stress and relapse in MS but not the disease onset.

The Prevalence and Association of Depression and Anxiety With Multiple Sclerosis in Riyadh, Saudi Arabia: A Cross-Sectional Study

“…A previous study concluded that most MS patients' relationships with partners, children and close friends were happy and healthy, factors which have an impact on mental health [22]. Being married was associated with a good prognosis in terms of disease progression [23]. These findings are consistent with our findings showing a significant difference in social status, in that people who were widowed, divorced, and separated had significant depressive symptoms.…”

Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients

“…Third, the current study was based on subjective assessment and self-reporting of fatigue and thus was not able to identify its clear causes whether it was simply due to MS complications such as sleep disorders, endocrine dysfunction, and mood disorders, or rather a primary MS fatigue ( 22 ). Finally, this study did not take into account the role of social support on coping strategies for MS patients, which might affect the quality of the results ( 21 ).…”

“…Some studies reported that up to 90% of pwMS had symptoms of fatigue, whereby they defined fatigue as tiredness, low energy, or exhaustion, and that these symptoms might be triggered by activities or increased temperature ( 11 , 12 , 14 ). Factors contributing to fatigue may include the individual presentation of the disease, some treatment side effects, functional status impairment, weakness, pain, and nocturia ( 21 ). Moreover, a study by Ayache and Chalah reviewed various causes of fatigue in pwMS which included anemia, vitamin-deficiencies, endocrine disorders, sleep disorders, psychiatric comorbidities, psychological burden, and medication side effects ( 22 ).…”

The Epidemiology of COVID-19 and MS-Related Characteristics in a National Sample of People With MS in China

“…Stressful events, such as natural disasters and certain life events, have been proven to induce immunological alterations (22)(23)(24), which led us to speculate that stress caused by the COVID-19 pandemic (25) could impact the course of MS. However, in this study, we observed a significantly increased relapse rate only in patients who experienced treatment disruption due to COVID-19, not in patients who received continuous treatment or who had no immunotherapy.…”