Depression and MS
The issue of depression and MS is an important one. Depression is very common in people with MS, being diagnosed in around 50% of people with MS at some time during the course of the disease. One Italian study found that 46% of patients in their study had major depressive disorder1 and a Norwegian study revealed that 59% of patients assessed had depression.2 An Australian study found higher rates, with 67% of surveyed people with MS being depressed.3 One in four people with MS probably has unrecognized and undiagnosed symptoms of depression.4 The single most important factor in determining the quality of life of people with MS is not disability or fatigue or work, but the presence or absence of depression.5
This has been supported by a US depression and MS study showing that depression was the best predictor of quality of life for people with MS, and that cognitive function was the best predictor of ability to work.6 A major US consensus statement on depression in MS reported that depression was common in MS, had a major negative impact on quality of life, and was under-recognised and under-treated.7
This has been supported by a US depression and MS study showing that depression was the best predictor of quality of life for people with MS, and that cognitive function was the best predictor of ability to work.6 A major US consensus statement on depression in MS reported that depression was common in MS, had a major negative impact on quality of life, and was under-recognised and under-treated.7
Researchers have looked at depression in MS and compared it with the incidence of depression in other chronic diseases.8 They found that depression is a specific feature of MS. That is, while having MS can cause one to get depressed, as can non-specific factors in having a chronic disease in general, there is something very specific about the disease process in MS which makes people with MS much more likely to get depressed.
So, depression and MS are closely related, and avoiding depression takes on a much more important role in the management of this illness than is generally recognized. There is an important role here for diet, exercise, counseling and keeping a diary in preventing depression, but it is important to note that there is also longstanding evidence that the low vitamin D levels are likely to precipitate or exacerbate depression and poor cognitive function.9-12 This is a further reason to ensure that people with MS get adequate sun exposure, or take vitamin D supplements if that is not possible. These lifestyle therapies can be very effective in preventing depression, as well as staying well, and these go hand in hand.
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So, depression and MS are closely related, and avoiding depression takes on a much more important role in the management of this illness than is generally recognized. There is an important role here for diet, exercise, counseling and keeping a diary in preventing depression, but it is important to note that there is also longstanding evidence that the low vitamin D levels are likely to precipitate or exacerbate depression and poor cognitive function.9-12 This is a further reason to ensure that people with MS get adequate sun exposure, or take vitamin D supplements if that is not possible. These lifestyle therapies can be very effective in preventing depression, as well as staying well, and these go hand in hand.
- Galeazzi GM, Ferrari S, Giaroli G, et al. Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy. Neurol Sci 2005; 26:255-262
- Figved N, Klevan G, Myhr KM, et al. Neuropsychiatric symptoms in patients with multiple sclerosis. Acta Psychiatr Scand 2005; 112:463-468
- Khan F, McPhail T, Brand C, et al. Multiple sclerosis: disability profile and quality of life in an Australian community cohort. Int J Rehabil Res 2006; 29:87-96
- McGuigan C, Hutchinson M. Unrecognised symptoms of depression in a community-based population with multiple sclerosis. J Neurol 2005
- D’Alisa S, Miscio G, Baudo S, et al. Depression is the main determinant of quality of life in multiple sclerosis: A classification-regression (CART) study. Disabil Rehabil 2006; 28:307-314
- Benedict RH, Wahlig E, Bakshi R, et al. Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. J Neurol Sci 2005; 231:29-34
- The Goldman Consensus statement on depression in multiple sclerosis. Mult Scler 2005; 11:328-337
- Even C, Friedman S, Dardennes R, et al. [Prevalence of depression in multiple sclerosis: a review and meta-analysis.]. Rev Neurol (Paris) 2004; 160:917-925
- Lansdowne AT, Provost SC. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl) 1998; 135:319-323.
- Gloth FM, 3rd, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging 1999; 3:5-7
- Stumpf WE, Privette TH. Light, vitamin D and psychiatry. Role of 1,25 dihydroxyvitamin D3 (soltriol) in etiology and therapy of seasonal affective disorder and other mental processes. Psychopharmacology (Berl) 1989; 97:285-294
- Jorde R, Waterloo K, Saleh F, et al. Neuropsychological function in relation to serum parathyroid hormone and serum 25-hydroxyvitamin D levels The Tromso study. J Neurol 2005
- Galeazzi GM, Ferrari S, Giaroli G, et al. Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy. Neurol Sci 2005; 26:255-262
- Figved N, Klevan G, Myhr KM, et al. Neuropsychiatric symptoms in patients with multiple sclerosis. Acta Psychiatr Scand 2005; 112:463-468
- Khan F, McPhail T, Brand C, et al. Multiple sclerosis: disability profile and quality of life in an Australian community cohort. Int J Rehabil Res 2006; 29:87-96
- McGuigan C, Hutchinson M. Unrecognised symptoms of depression in a community-based population with multiple sclerosis. J Neurol 2005
- D’Alisa S, Miscio G, Baudo S, et al. Depression is the main determinant of quality of life in multiple sclerosis: A classification-regression (CART) study. Disabil Rehabil 2006; 28:307-314
- Benedict RH, Wahlig E, Bakshi R, et al. Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. J Neurol Sci 2005; 231:29-34
- The Goldman Consensus statement on depression in multiple sclerosis. Mult Scler 2005; 11:328-337
- Even C, Friedman S, Dardennes R, et al. [Prevalence of depression in multiple sclerosis: a review and meta-analysis.]. Rev Neurol (Paris) 2004; 160:917-925
- Lansdowne AT, Provost SC. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl) 1998; 135:319-323.
- Gloth FM, 3rd, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging 1999; 3:5-7
- Stumpf WE, Privette TH. Light, vitamin D and psychiatry. Role of 1,25 dihydroxyvitamin D3 (soltriol) in etiology and therapy of seasonal affective disorder and other mental processes. Psychopharmacology (Berl) 1989; 97:285-294
- Jorde R, Waterloo K, Saleh F, et al. Neuropsychological function in relation to serum parathyroid hormone and serum 25-hydroxyvitamin D levels The Tromso study. J Neurol 2005