TY - JOUR
T1 - Stressful life events and the risk of initial central nervous system demyelination
AU - Saul, Alice
AU - Ponsonby, Anne Louise
AU - Lucas, Robyn M.
AU - Taylor, Bruce V.
AU - Simpson, Steve
AU - Valery, Patricia
AU - Dwyer, Terence
AU - Kilpatrick, Trevor J.
AU - Pender, Michael P.
AU - Van Der Mei, Ingrid A.F.
N1 - Publisher Copyright:
© SAGE Publications.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: There is substantial evidence that stress increases multiple sclerosis disease activity, but limited evidence on its association with the onset of multiple sclerosis. Objective: To examine the association between stressful life events and risk of first demyelinating event (FDE). Methods: This was a multicentre incident case-control study. Cases (n = 282 with first diagnosis of central nervous system (CNS) demyelination, including n = 216 with 'classic FDE') were aged 18-59 years. Controls without CNS demyelination (n = 558) were matched to cases on age, sex and study region. Stressful life events were assessed using a questionnaire based on the Social Readjustment Rating Scale. Results: Those who suffered from a serious illness in the previous 12 months were more likely to have an FDE (odds ratio (OR) = 2.35 (1.36, 4.06), p = 0.002), and when we limited our reference group to those who had no stressful life events, the magnitude of effect became stronger (OR = 5.41 (1.80, 16.28)). The total stress number and stress load were not convincingly associated with the risk of an FDE. Conclusion: Cases were more likely to report a serious illness in the previous 12 months, which could suggest that a non-specific illness provides an additional strain to an already predisposed immune system.
AB - Background: There is substantial evidence that stress increases multiple sclerosis disease activity, but limited evidence on its association with the onset of multiple sclerosis. Objective: To examine the association between stressful life events and risk of first demyelinating event (FDE). Methods: This was a multicentre incident case-control study. Cases (n = 282 with first diagnosis of central nervous system (CNS) demyelination, including n = 216 with 'classic FDE') were aged 18-59 years. Controls without CNS demyelination (n = 558) were matched to cases on age, sex and study region. Stressful life events were assessed using a questionnaire based on the Social Readjustment Rating Scale. Results: Those who suffered from a serious illness in the previous 12 months were more likely to have an FDE (odds ratio (OR) = 2.35 (1.36, 4.06), p = 0.002), and when we limited our reference group to those who had no stressful life events, the magnitude of effect became stronger (OR = 5.41 (1.80, 16.28)). The total stress number and stress load were not convincingly associated with the risk of an FDE. Conclusion: Cases were more likely to report a serious illness in the previous 12 months, which could suggest that a non-specific illness provides an additional strain to an already predisposed immune system.
KW - First demyelinating event
KW - first clinical diagnosis
KW - multiple sclerosis
KW - risk factors
KW - stress
KW - stressful life events
UR - http://www.scopus.com/inward/record.url?scp=85020164775&partnerID=8YFLogxK
U2 - 10.1177/1352458516667566
DO - 10.1177/1352458516667566
M3 - Article
SN - 1352-4585
VL - 23
SP - 1000
EP - 1007
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 7
ER -