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

Abstract

BackgroundDepression 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.MethodsThis 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).ResultsIn 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.ConclusionsThis 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.

Serum Anti-Müllerian Hormone Levels in Multiple Sclerosis: A Case Control Study

“…In line with the previous studies, high BMI and obesity are two of the significant and possible risk factors for MS which have deleterious functional effects on the patients [13][14][15]. In contrast to the previous studies detected childlessness in MS patients [16], the current findings were consistent with a recent pilot study [11].…”

Sexual function in multiple sclerosis and associations with demographic, disease and lifestyle characteristics: an international cross-sectional study

“…We have previously demonstrated modifiable lifestyle factors are important predictors in their own right of fatigue [32] and depression risk [33], and may therefore indirectly affect sexual function and satisfaction with sexual function. Here, we were able to demonstrate that diet and level of physical activity are associated with these outcomes even after adjusting for other relevant factors.…”

“…There is potential for a lifestyle risk factor modification approach to the management of SD in PwMS, given the strong associations of better lifestyle behaviours with reduced depression risk [33] and fatigue [32], both known to adversely affect sexual function [22]. In type 2 diabetes, another chronic disease with strong lifestyle associations, intensive lifestyle intervention in obese women resulted in a significantly greater proportion remaining sexually active, improvements in sexual function, and greater likelihood of remission of SD at 1 year [43].…”

Lifestyle, medication and socio-demographic determinants of mental and physical health-related quality of life in people with multiple sclerosis

“…Adopting healthy behaviours may be indirectly associated with QOL, as an externally oriented locus of control, with a feeling of being unable to influence health outcomes, predicts worse disability but also depression and fatigue [42], both determinants of QOL in their own right, and both strongly associated with the lifestyle factors examined here [43, 44]. Having healthy behaviours may be associated with positive orientation of locus of control, with attendant benefits in motivation to access health information and better adherence to treatment [42].…”