Abstract
Background Studies suggest stress increases the risk of relapses and reduces quality of life in people with MS but few have examined the effect of stressful life events (SLEs) on disease progression.
Objective To investigate the associations between SLE number and individual SLEs and the frequencies of relapse, disability severity, depression-risk, and fatigue in people with MS.
Methods Cross-sectional analysis of data from an online cohort of people with MS was performed (n=948). SLEs were assessed using a subset of 16 SLEs from the Holmes-Rahe Social Readjustment Rating Scale. SLE relationships with relapse, disability severity, depression-risk, and fatigue were assessed by log-binomial or log-multinomial regression, as appropriate, adjusted for age, sex, education, MS type, disability, fatigue, comorbidities, ongoing relapse symptoms, and antidepressant/anti-fatigue , as appropriate.
Results The average number of SLEs was 1.8(range 0–9). SLE number was associated with 10%(95%CI;1–20) and 8%(95%CI;3–14) more frequent depression-risk and fatigue, respectively, but no associations with relapse or disability were found. Depression-risk was more frequent in individuals with serious illness [30%(95%CI;3%-64%)], work/school/career crisis/serious disappointment [38%(95%CI;0%-88%)], and new family members [2.47-fold(95%CI;1.21–5.07)]. Fatigue was more frequent in individuals with serious illness [22%(95%CI;7%-39%)] and starting/resuming serious relationships [2.31-fold(95%CI;1.78–2.98)].
Conclusion SLE number and individual SLEs were associated with greater depression-risk and fatigue. Defining the impact of SLEs on health outcomes may help inform behavioural and/or intervention strategies to improve health outcomes in people with MS.
