Canadian Study Links Psychiatric Disorders and Physical Disability in Women with MS
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Depression, anxiety and other mood disorders contribute to physical disability in women with multiples sclerosis, according to a Canadian study that confirmed the results of previous research.
The article the team wrote, “Psychiatric comorbidity is associated with disability progression in multiple sclerosis,” appeared in the journal Neurology.
Several studies have suggested that psychiatric disorders are common among MS patients. Brain inflammation linked to MS’s underlying mechanisms has been reported as a potential driver of depression and anxiety in patients with relapsing-remitting multiple sclerosis (RRMS). Also, children with MS are known to be more susceptible to psychiatric disorders than other children.
These findings raise the question of whether psychiatric disorders contribute to MS progression and patient outcomes.
A Canadian team decided to study the issue. The team, led by Dr. Ruth Ann Marrie of the University of Manitoba, analyzed records on 2,312 adults who had been diagnosed with MS, 76 percent of whom were women with relapsing MS.
The records were from two provinces that represent about 15 population of the Canadian population — the British Columbia Multiple Sclerosis database and Nova Scotia’s Dalhousie Multiple Sclerosis Research Unit database.
During a follow-up period ranging from 6.2 to 14.8 years, 36 percent of the patients developed a mood or anxiety disorder. The most common was depression (37 percent), followed by anxiety (22 percent), and bipolar disorder (5 percent).
In results that were in line with previous reports, researchers found that patients with a mood or anxiety disorder had worse physical disability scores, measured by scores on the expanded disability status scale (EDSS). This trend was found in both men and women, but it was only statistically significant in women.
For a more detailed understanding of the association, the team re-analyzed data according to individual disorder. They found that only depression was significantly associated with higher EDSS scores. This suggested that anxiety and bipolar disorder did not contribute to physical disability in MS patients.
Collectively, the results suggested that psychiatric disorders, particularly depression, can contribute to MS progression and the “severity of subsequent neurologic disability,” the researchers wrote.
“Optimizing management of psychiatric comorbidities [disorders] should be explored as a means of potentially mitigating disability progression in MS,” the team suggested.
Ali
How do they prove that the depression / anxiety is not caused by having greater disability? Correlation does not imply causation. i.e. how can they state depression is causing disability, and not the other way around.
LAURIE
I agree with you 100%.
Carmel Clarke
Indeed. You are making good sense!
Renee
I agree!
Birdie K.
That was my thought, also, Ali. I have PPMS and I know I can get depressed because my body isn’t functioning well but I can never recall a time where it felt like my symptoms were getting worse because I was depressed.
Alicia Wade
I agree with you also! Disability and loss of function causes depression!
Amanda
Although correlation and causation are different a good study will look at relationship from many angles and try to determine the most probably relationship. It would not be the first time they got it wrong but it also would not be the first time the people were wrong - think about the world being round or gravity both concepts that were not accepted but later proven true. This is an early student and now we have a theory that over time will either be supported by more information or proven wrong. Overall I have very little disability but some days it does not stop me from being very depressed or worse yet having anxiety issues which all started just a few months before I got the official MS diagnosis.
Brenda Douglas
I never remember having depression before I had symptoms of MS. I hope this study is thorough. Anxiety and depression have become more prevalent and troublesome since my MS has progressed.
Shirley A. Nobbs
Anxiety issues make MS symptoms worse causing depression and lassitude.
CAS
What about those who were diagnosed with a mood disorder prior to ms diagnosis?
Karen Junqueira
I definitely experience that my physical abilities deteriorate when I experience stress/depression/anxiety. Once I remove the stress, my physical abilities improve and I feel much stronger and able.
jane
I am sure that all physical disabilities cause people to feel depressed but also feeling depressed almost always makes pain and difficulty moving about worse. What the study does not seem to have looked at, is whether if people get some counselling or talking support for their depression, they improve physically or psychologically or both. I suspect that both would improve substantially.
Stephanie
I was diagnosed bipolar/anxiety years before the MS diagnosis. But it is hard to tell how everything lines up together. I had massive bipolar depression/mania around the same time ms stuff started when I was 14. I think doctors not believing all the symptoms contributed big time to the severity of the bipolar. I still have days that really drag me down.
Debbie Larson
I think they can suck my non-existent dick. I never had any of those problems prior to diagnosis.IT wasn't until later after body parts stopped working and cognitive issues.
Kimberly Smith
I have had symptoms for years but they came up so sporadically that no doctor connected them and finally after what my husband thought was a mini-stroke I had three MRIs,loads of blood tests and numerous other tests and was diagnosed with multiple sclerosis at the age of 49 on November7,2017 and my neurologist said she believes I have had it for years because the lesions are already on the lining of my brain,in my neck and my upper back. I have to admit I'm scared because I can't find a job and the thing I have read are not to promising.
Ann
I think my depression and anxiety lead to less activity and exercise. It hurts to exercise, but I know I have to do it. Going to PT helps. MS really sucks when you can't work and are in disability. I am the poor class with a masters degree. All my money goes to pay medical bills and pills.
Debbie
I am with you, Ann. A Master's Degree and living poor. All the years I worked so hard on my career. Now I am 57 years old and living poor. Why would I be depressed, have anxiety issues, and stress?
Betty
Was VERY depressed (& unmedicated!) for 12 yrs PRIOR to MS dx.
Very mild course of RRMS allowed me to remain very active for 18 yrs (!), then Fatigue.
Since Fatigue, struggled to keep working and stay active. Finally stopped working & driving. Activity WAY down now.
Depression - medicated for past 19 yrs. - got no worse over all this time.
That’s my anecdote.
Maria Scripture
Probably having started when I was in Jr. High school, I seriously think I've always been depressed. I'm 46 now and 1/3 of my brain is scar tissue.