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The impact of stressful life events on risk of relapse in women with multiple sclerosis: A prospective study

Published online by Cambridge University Press:  07 September 2008

Charalampos I. Mitsonis ,
Iannis M. Zervas ,
Panagiotis A. Mitropoulos ,
Nikolaos P. Dimopoulos ,
Constantin R. Soldatos ,
Constantin M. Potagas  and
Constantin A. Sfagos
Charalampos I. Mitsonis*
Affiliation:
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 7, Metamorfoseos Street, GR-15234 Halandri, Athens, Greece
Iannis M. Zervas
Affiliation:
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 72, Vas. Sofias Avenue, GR-11528Athens, Greece
Panagiotis A. Mitropoulos
Affiliation:
Department of Business Administration, University of Patras, 145 Theofrastou, GR-23335Patras, Greece
Nikolaos P. Dimopoulos
Affiliation:
Dromokaition Psychiatric Hospital, 343, Iera Odos, GR-12461Athens, Greece
Constantin R. Soldatos
Affiliation:
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 72, Vas. Sofias Avenue, GR-11528Athens, Greece
Constantin M. Potagas
Affiliation:
Department of Neurology, Athens University Medical School, Eginition Hospital, 72, Vas. Sofias Avenue, GR-11528Athens, Greece
Constantin A. Sfagos
Affiliation:
Department of Neurology, Athens University Medical School, Eginition Hospital, 72, Vas. Sofias Avenue, GR-11528Athens, Greece
*
*Corresponding author. Tel.: +30 210 807 2483; fax: +30 210 514 5824; mobile: +30 6945 371 700. E-mail address: [email protected] (C.I. Mitsonis), [email protected] (I.M. Zervas), [email protected] (P.A. Mitropoulos), [email protected] (C.R. Dimopoulos), [email protected] (C.R. Soldatos), [email protected] (C.M. Potagas), [email protected] (C.A. Sfagos).
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Abstract

Purpose

The aims of this study were first, to examine the general relation between stressful life events (SLEs) and clinical relapses in women with multiple sclerosis (MS) and second, to investigate the relations of the specific stressor attributes of duration, type, and severity on MS exacerbations.

Methods

Twenty six ambulating women with relapsing-remitting MS were followed-up for a mean of 56.3 weeks. Patients documented SLEs weekly in self report diaries which were then collected at regular pre-scheduled clinic visits every 4 weeks. SLEs were classified as short-term if they had subjectively no lasting effect and long-term if they had a subjectively felt psychological impact that lasted at least 10–14 days after the event. The severity of SLEs was determined using the Recent Life Change Questionnaire.

Results

Experiencing three or more SLEs, during a 4-week period, was associated with a 5-fold increase of MS relapse rate (95% CI 1.7–16.4, p = 0.003). The presence of at least one long-term SLE was associated with three times (95% CI 1.01–9.13, p < 0.05) the rate of MS exacerbation during the following 4 weeks. There was no significant association between the severity (95% CI 0.99–1.01, p > 0.05) or the type (χ2 = 7.29, df = 5, p > 0.05) of stressor and the risk for relapse.

Conclusion

Ambulatory women with relapsing-remitting MS who experience cumulative SLEs may be at a greater risk for relapse. Duration is the only stress attribute that seems to increase the risk for relapsing in contrast to stress type and stress severity that were not found to interact with MS exacerbation.

Keywords

Multiple sclerosisRelapseRiskStress attributesStressful life events
Type
Original article
Information
European Psychiatry , Volume 23 , Issue 7 , October 2008 , pp. 497 - 504
Copyright
Copyright © Elsevier Masson SAS 2008

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