Stress May Trigger Multiple Sclerosis Flare-Ups In Women

Researchers recruited 23 women with MS from the Multiple Sclerosis Clinic at the University of Pittsburgh Medical Center and followed them for a year. Each week, the women completed questionnaires asking about MS symptoms and life events, such as starting a new job, finding out that a child is doing poorly in school, having a motor vehicle accident, and being physically assaulted.

Every four weeks, the women were interviewed about the nature and timing of life events they had experienced, and the life events data were later analyzed with the MS exacerbation data.

"A controversial issue in multiple sclerosis research concerns the extent to which psychological stress contributes to the development and progression of the disorder," writes researcher Kurt D. Ackerman, M.D., Ph.D., and co-investigators in the Departments of Psychiatry, Neurology, Pathology and Psychology at the University of Pittsburgh.

"This study contributes to a growing body of evidence that stressful life events are potent triggers of disease activity in women with relapsing-remitting MS," they add. "MS exacerbations may be delayed or avoided by limiting the individual or cumulative effects of stressful life events."

Their results are published in the November-December issue of Psychosomatic Medicine.

During the study year, the women experienced an average of 2.6 MS exacerbations that lasted an average of 29 days. Eighty-five percent of the MS exacerbations were associated with at least one stressful life event in the prior six weeks.

The results also showed that stressors from different sources and of different levels of severity were equally associated with exacerbations. In addition, the researchers found that stress led quickly to MS exacerbations, with an average of 14 days from the stressful event to the flare-up.

The researchers further suggest that preventive strategies, such as coping skills training and early interventions for symptoms of anxiety and depression, could help women avoid stress-induced MS flare-ups.

MS is a life-long neurological disease that is usually diagnosed in young adults. According to the National Institute of Neurological Disorders and Stroke, as many as 350,000 people in the United States have been diagnosed with MS, and approximately 200 new cases are diagnosed each week. In general, women are affected by MS at almost twice the rate of men.

The research was supported by grants from the National Institutes of Health.