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

Taylor, Keryn L; Hadgkiss, Emily; Jelinek, George A; Weiland, Tracey; Pereira, Naresh G; Marck, Claudia H; Meer, Dania M van der

doi:10.1186/preaccept-6871346891381394

Cited by 19 publications

(31 citation statements)

References 48 publications

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“…Observational studies in people with MS have consistently shown an association between physical inactivity and depression as well as excessive alcohol use and depression, so our results here are in keeping with these prior findings. We did not find an association between BMI and depression prevalence or severity, however, which is inconsistent with previous studies . This could reflect differences in study design or populations; however, this is mere speculation and more research is needed to clarify this.…”

Section: Discussionsupporting

confidence: 89%

“…Every unit increase in SNAP score was associated with a 17% reduction in prevalent depression and a 0.44 unit lower actual HADS‐depression score. The findings are in line with previous work showing that smoking and poor diet were associated with increased risk of depression in people with MS . Research into the mechanisms between diet and mood is still emerging, but evidence for this association is strong within the general population .…”

Section: Discussionmentioning

confidence: 99%

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Modifiable factors associated with depression and anxiety in multiple sclerosis

et al. 2019

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Objectives Modifiable lifestyle factors are implicated in multiple sclerosis (MS) symptoms but their role in mood is unclear. This study aimed to investigate associations between lifestyle and depression and anxiety in Australian participants with MS. Materials and Methods Self‐reported data from the Australian Multiple Sclerosis Longitudinal Study included the Hospital Anxiety and Depression Scale (HADS) and lifestyle measurements from 1500 participants. SNAP score (range 0‐5) was the sum of non‐smoking, sufficient fruit/vegetable intake, non‐hazardous alcohol consumption, sufficient physical activity and healthy BMI. Analyses by log‐binomial and linear regression were adjusted for confounding. Results Symptoms of depression and anxiety were prevalent in 27% and 40%, respectively; 20% had both. Mean SNAP score was 2.7/5; only 3% met all healthy lifestyle recommendations. Only 10% reported adequate fruit/vegetable intake, and 22% reported a combination of unhealthy BMI, inadequate physical activity and inadequate nutrition. A healthier SNAP score was associated with lower depression prevalence (adjusted prevalence ratio 0.83 [95% CI 0.75, 0.92] per unit increase) and depression severity (adjusted β‐0.44 [95% CI −0.64, −0.24]), but not with anxiety. Conclusions Modifiable lifestyle factors are associated with lower frequency and severity of depression, but not anxiety, in Australian people with multiple sclerosis. The associations between a healthier SNAP score and lower depression are likely bi‐directional. SNAP risk factor prevalence and co‐occurrence, especially inadequate nutrition and low physical activity, were high among Australians with MS.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Modifiable factors associated with depression and anxiety in multiple sclerosis

et al. 2019

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“…There is no strong evidence to link Vitamin D insufficiency with HPA-axis dysregulation. However, Vitamin D remains a worthy candidate for further investigation as a therapeutic option for PD due to the strong evidence that Vitamin D metabolism exerts a significant influence over the progression of other neurological conditions such as multiple sclerosis ( 314 ) and supplementation with omega-3 fatty acids significantly reduces the risk of depression ( 315 ).…”

Section: Depression In Parkinson’s Diseasementioning

confidence: 99%

Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases?

2015

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There is increasing evidence of prodromal manifestation of neuropsychiatric symptoms in a variety of neurodegenerative diseases such as Parkinson’s disease (PD) and Huntington’s disease (HD). These affective symptoms may be observed many years before the core diagnostic symptoms of the neurological condition. It is becoming more apparent that depression is a significant modifying factor of the trajectory of disease progression and even treatment outcomes. It is therefore crucial that we understand the potential pathophysiologies related to the primary condition, which could contribute to the development of depression. The hypothalamic–pituitary–adrenal (HPA)-axis is a key neuroendocrine signaling system involved in physiological homeostasis and stress response. Disturbances of this system lead to severe hormonal imbalances, and the majority of such patients also present with behavioral deficits and/or mood disorders. Dysregulation of the HPA-axis is also strongly implicated in the pathology of major depressive disorder. Consistent with this, antidepressant drugs, such as the selective serotonin reuptake inhibitors have been shown to alter HPA-axis activity. In this review, we will summarize the current state of knowledge regarding HPA-axis pathology in Alzheimer’s, PD and HD, differentiating between prodromal and later stages of disease progression when evidence is available. Both clinical and preclinical evidence will be examined, but we highlight animal model studies as being particularly useful for uncovering novel mechanisms of pathology related to co-morbid mood disorders. Finally, we purpose utilizing the preclinical evidence to better inform prospective, intervention studies.

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“…3,8 People with MS have many stressors due to their disease. Psychological problems such as denial of disease, depression, anxiety, and negative changes in lifestyle and decreased social interactions affect up to 80% of people with MS. 9,10 Moreover, symptoms such as pain, blurred vision, fatigue, dizziness, physical imbalance, and urologic and sexual dysfunctions negatively affect health-related quality of life in these patients. 11 Therefore, coping with such problems may be a key to the management of MS and its associated symptoms.…”

Section: The Jcsmentioning

confidence: 99%