The interrelation between chronic stress and multiple sclerosis (MS) has always been known, but biological foundation for this phenomena has not yet been proven. Few clinical trials were performed to analyse this connection.

Our objective was to analyse the possible role of chronic stress in development and reoccurance of MS. Throughout case series the authors described different clinical manifestations of these relations.

Six patients (two female and four male) with diagnoses of chronic combat-related PTSD and multiple sclerosis were selected as the sample for this study. None of the patients have family history of MS nor were they diagnosed with multiple sclerosis before or during the war. On the base of psychiatric interviews, medical records and different self-reported questionnaires the authors analysed the relation between the symptomatology of PTSD and MS, as well as different treatment strategies that were used.

Patients had severe progress of the symptoms of MS. Higher intensity of PTSD symptoms were followed by the egzacerbations of the symptomatology of MS and vice versa. We propose that there is a positive feedback between chronic stress and MS. This implicates that each of these conditions could worsen the symptoms of the other ones. Our findings show the need for multidisciplinary approach in the treatment of patients with chronic PTSD and comorbid multiple sclerosis, which will optimize treatment and result in more cost-effective care. Appropriate identification and optimal pharmacological interventions for both disorders might modify further chronification of those disorders and thus influence better outcome.