Stress and the risk of multiple sclerosis

Abstract

Objective: Several studies have shown that stressful life events are associated with a subsequent significant increase in risk of multiple sclerosis (MS) exacerbations. We wanted to study prospectively whether stress can increase the risk of developing the disease itself. Methods:We studied 2 cohorts of female nurses: the Nurses' Health Study (NHS) (n ϭ 121,700) followed from 1976 and the Nurses' Health Study II (NHS II) (n ϭ 116,671) followed from 1989. The risk of MS after self-report on general stress at home and at work in the NHS in 1982 was studied prospectively using Cox regression. Logistic regression was used to retrospectively estimate the effects of physical and sexual abuse in childhood and adolescence collected in the NHS II 2001. We identified 77 cases of MS in the NHS by 2005 and 292 in the NHS II by 2004. All analyses were adjusted for age, ethnicity, latitude of birth, body mass index at age 18, and smoking. Results:We found no increased risk of MS associated with severe stress at home in the NHS (hazard ratio 0.85 [95% confidence interval (CI)] 0.32-2.26). No significantly increased risk of MS was found among those who reported severe physical abuse during childhood (odds ratio [OR] 0.68, 95% CI 0.41-1.14) or adolescence (OR 0.77, 95% CI 0.46-1.28) or those having been repeatedly forced into sexual activity in childhood (OR 1.47, 95% CI 0.87-2.48) or adolescence (OR 1.21, 95% CI 0.68-2.17). Conclusions:These results do not support a major role of stress in the development of the disease, but repeated and more focused measures of stress are needed to firmly exclude stress as a potential risk factor for MS. Neurology Multiple sclerosis (MS) is a chronic autoimmune disease affecting the CNS with unknown causes. It appears that the etiology is multifactorial, including both genetic and environmental components.

Multiple Sclerosis in Gulf War Era Veterans. 2. Military Deployment and Risk of Multiple Sclerosis in the First Gulf War

“…Stressful life events have been associated with MS exacerbations in a number of studies [30] but the results have not been consistent [31]. As such, the psychological stress of war may be a factor in initiating MS-related symptoms.…”

The experiences of individuals with Multiple Sclerosis in the Western Cape, South Africa

“…For example, women suffering from MS face the challenge of decisions about having children, especially when considering their ability to care for a baby; these challenges include fatigue, financial concerns and support, societal attitudes and concerns about passing on the genetic predisposition to developing MS (Payne & McPherson 2010;Prunty et al 2008). Another facet of this multidimensional experience of MS is stress, possibly relating to the onset, progression or exacerbation of symptoms; the possibility of having to move houses because stairs or a large property might become impractical in light of MS-related physical impairments; the loss of employment; and the challenges of practical tasks such as grocery shopping and looking after the family (Malcomson et al 2008;Riise et al 2011). Often, individuals living with MS also seem to experience psychological distress.…”

Role of Socioeconomic Position in Multiple Sclerosis Etiology

“…A German case-control study of 1100 individuals reported MS cases had increased odds of reporting emotional abuse, sexual abuse, emotional neglect and severe abuse (p < 0.05), but not physical abuse or neglect, compared with community-based controls [66]. However, in the Nurses' Health Study (77 MS cases) and the NHS-II (292 MS cases), there was no evidence for increased physical or sexual abuse in childhood/adolescence among MS cases [67]. In addition, a retrospective cohort study of hospital discharge records observed increased rates of first hospitalizations for MS patients who experienced traumatic childhood stress [68].…”