Stressful life events and multiple sclerosis: a retrospective study

Palumbo, Roberto; Fontanillas, L.; Salmaggi, Andrea; Mantia, L. La; Milanese, C.

doi:10.1007/bf02427615

Cited by 11 publications

(24 citation statements)

References 7 publications

(9 reference statements)

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“…Only 1 of the 6 studies concerning onset was designated as a retrospective cohort study [30] . The remaining 5 [23,39,[44][45][46] were case-control studies, and 1 of them, by Warren et al [46] , elaborated on the results of a previous publication and was excluded. Regarding MS relapse, 9 studies were designated as cohort studies (follow-up) [26][27][28][29][32][33][34][35][36] , 3 as case-control studies [37,40,43] , 5 as cross-sectional studies, and 1 as a case series.…”

Section: Resultsmentioning

confidence: 99%

“…All but one study by Palumbo et al [39] report valid criteria for MS diagnosis. Stress measurement was mainly focused on the environmental approach to stress, meaning that patients were asked questions about stressors in their lives, either in the form of interviews or by record linkage to stressful events such as loss of a child in the cohort study [30] .…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The only exception were Warren et al [45] , who also asked patients about how unwanted the stress by the stressor they had described was, in relation to their usual experience. Palumbo et al [39] and Warren et al [45] were the only research teams that used unvalidated interviews. As seen in table 2 , there is limited information about disease duration and disability, with a trend towards below 10 years and limited disability, respectively.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Regarding MS onset studies, all but one gave an adequate definition of MS diagnosis [39] . Two studies were found to be prone to selection bias due to the lack of a consecutive case selection or obviously representative series of cases [39,44] .…”

Section: Case-control Studiesmentioning

confidence: 99%

“…As seen in table 2 , there is limited information about disease duration and disability, with a trend towards below 10 years and limited disability, respectively. Two case-control studies [39,44] focused on stress occurrence 1 year prior to onset of symptoms, one study at 2 years prior to onset [45] , and one study at 3 years prior to diagnosis of MS [23] .…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Stress as a Risk Factor for Multiple Sclerosis Onset or Relapse: A Systematic Review

2011

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Background: Stress has been considered a triggering factor for multiple sclerosis (MS) since the description of the disease by Jean-Martin Charcot. Until our times, many published studies have supported that both MS onset and relapse could be predisposed by psychological stress. This review aims to synthesize existing knowledge of the relationship between psychological stress and MS onset and relapse, focusing mainly on the quality of observational studies. Methods: We hand-searched MEDLINE with the terms ‘stress and multiple sclerosis’, using English language restrictions, from January 1980 to November 2010. We included only observational longitudinal studies. The Newcastle-Ottawa scale proposed by the Cochrane Collaboration was used for assessing the quality of the observational studies. Results: Seventeen publications were analyzed, 5 for MS onset (1 cohort and 4 case-control studies) and 12 for MS relapse (9 cohort and 3 case-control studies). We found a marked heterogeneity in stress measurement that mostly targeted the environmental approach to stress. Only 2 publications used radiological criteria for MS relapse. Quality issues were identified mainly for comparability, meaning that studies failed to control adequately for various triggering and psychosocial factors in the stress-MS relationship. Also, selection and blinding problems were identified in most case-control studies. All studies, with only 2 exceptions, resulted in favor of the stress-MS relationship, but due to marked stress measurement heterogeneity, no secure conclusions could be drawn. Conclusions: Future studies should incorporate a multidisciplinary approach to stress measurement and radiological criteria for MS. We further encourage researchers to test the effect of early life stress and stress management techniques on the clinical course of the disease.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Case-control Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Stress as a Risk Factor for Multiple Sclerosis Onset or Relapse: A Systematic Review

2011

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Stress-full life events and multiple sclerosis: A population-based incident case-control study

Abdollahpour

Mansournia

Eckert

et al. 2018

Multiple Sclerosis and Related Disorders

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Stressful life events are associated with the risk of multiple sclerosis

Jiang

Olsson

Hillert

et al. 2020

Euro J of Neurology

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Background and purpose Unexpected stressful life events may alter immune function and affect susceptibility to autoimmune diseases including multiple sclerosis (MS). Current results from epidemiological investigations examining the role of stress in MS remain inconsistent. The aim was to conduct the hitherto largest population‐based case–control study on this topic. Methods Extensive questionnaire information collected on lifestyle environmental factors available for 2930 incident MS cases and 6170 controls were used to assess the association of 10 major life events that had occurred before disease onset with the risk of MS by unconditional logistic regressions, adjusting for potential confounders. Stratified analyses were also performed by sex and time. Results Compelling evidence was found for a link between major life events and risk of MS – most events significantly increased disease risk by 17%–30%. It was further observed that women were affected to a greater extent than men under certain stressful scenarios, and that most events that happened recently (≤5 years prior to MS onset) had significant effects on MS, indicating a critical window in disease development. Conclusion Stressful life events may have an adverse effect on the risk of MS. Research into the mechanisms of this observation may give important clues to triggering pathogenetic events in MS.

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Stressful life events and multiple sclerosis: a retrospective study

Cited by 11 publications

References 7 publications

Stress as a Risk Factor for Multiple Sclerosis Onset or Relapse: A Systematic Review

Stress as a Risk Factor for Multiple Sclerosis Onset or Relapse: A Systematic Review

Stress-full life events and multiple sclerosis: A population-based incident case-control study

Stressful life events are associated with the risk of multiple sclerosis

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