From Denise Mann
HealthDay reporter
THURSDAY, September 2, 2021 (HealthDay News) – Depression and multiple sclerosis (MS) tend to travel together, new research shows, and when they do, the likelihood of dying can increase in the next decade to be five times higher is for those with no condition.
Why the combination is so deadly is not fully understood, but several factors could play a role, explained study author Dr. Raffaele Palladino, Research Associate at Imperial College London. For starters, depression is linked to inflammation and other brain changes that increase the risk of stroke.
“People with psychiatric disorders may not be treated as well for their cardiovascular risk factors, and depression has been linked to poorer health behaviors [diet, physical activity] which can negatively impact both MS and other health issues, “said Palladino.
Nearly 1 million people in the United States have MS when the immune system fails against the central nervous system, which is made up of the brain, spinal cord, and optic nerves. Symptoms range from mild to severe and can include numbness, fatigue, bladder problems, difficulty walking, and thinking and memory problems. A full 20% of people with MS also have depression, Palladino said.
For the study, the researchers reviewed the medical records of nearly 85,000 people with and without MS. They tracked who developed vascular disease or died over a period of 10 years. At the start of the study, 21% of people with MS were depressed, as was 9% of people without MS.
People with MS and depression were more than five times more likely to die from any cause than people without disease over the next decade, after the researchers controlled other factors that might influence the risk of death, such as smoking and diabetes.
The study showed that people with both diseases are more than three times more likely to develop vascular diseases than people with no disease.
A history of MS or depression also had an impact on the risk of death over the next 10 years. People with MS without depression were almost four times more likely to die than people with no disease, and people with depression without MS were almost twice as likely, the study showed.
It’s too early to say whether treating depression in people with MS will help improve vascular risk factors like inflammation in the brain and reduce the risk of death. Awareness of the symptoms of depression in MS and family support are vital, Palladino said.
Common symptoms of depression can be sadness, tears; Irritability; Loss of interest in normal activities; Sleep disorder; Fatigue; Changes in appetite; Feelings of guilt; Difficulty thinking and frequent thoughts of death, he said.
“Appropriate mental health screening followed by timely, effective intervention is an essential step in mitigation [depression’s] Last, “said Palladino.
The study appears in the September 1st issue of Neurology.
Two experts who did not participate in the study emphasized the importance of identifying and treating the signs of depression and vascular disease in people with MS.
This study identifies the link between MS and depression “and highlights the effects of this combination on vascular incident risk and all-cause mortality,” said Dr. Emily Pharr, Assistant Professor of Neurology at Wake Forest Baptist Medical Center in Winston-Salem, NC “These results underscore the importance of closely monitoring symptoms of depression and vascular risk factors in our MS patients.”
Julie Fiol, Associate Vice President of Health Care Access at the National MS Society, agreed. “The immediate clinical implications of these results are the importance of screening and treating depression in MS,” she said.
Depression in MS isn’t just a response to living with a chronic illness, noted Fiol.
“It’s also something biological that happens outside of the person’s control,” she said. “If left untreated, depression reduces the quality of life, makes other MS symptoms – including fatigue, pain, cognitive changes – feel worse and can be life-threatening.”
More information
Learn more about depression and MS at the National MS Society.
SOURCES: Raffaele Palladino, MD, PhD, Research Associate, Imperial College London, United Kingdom; Emily Pharr, MD, Assistant Professor, Neurology, Wake Forest Baptist Medical Center, Winston-Salem, NC; Julie Fiol, vice president, health care access, National MS Society, New York City; Neurology, September 1, 2021
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