Key Findings
Multiple sclerosis (MS) is a chronic autoimmune, inflammatory and demyelinating disease of the central nervous system. Depression is the most common psychiatric illness and co-morbidity for people with MS. There may be potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. In the Health Outcomes and Lifestyle Interventions in a Sample of People with Multiple Sclerosis (HOLISM) Study, the odds of screening positive for depression was roughly half in participants supplementing with omega 3 fatty acids, with a greater reduction for flaxseed oil than for those supplementing with fish oil alone or in combination with flaxseed oil. Epidemiological research indicates that low omega 3 fatty acid consumption is associated with higher rates of depression in the general population. The data strongly support a role for omega 3 supplementation in reducing depression risk in people with MS, in addition to its clear association with reduced risk of relapse. Modifiable lifestyle factors may reduce depression risk in MS.
ABSTRACT:
Background: Depression is the most common co-morbidity for people with Multiple Sclerosis (MS); irrespective of disease severity, depression has the greatest impact on quality of life. An emerging paradigm in the treatment of depression is lifestyle medicine. There is significant potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. This study sought to understand the association between lifestyle risk factors, medication and depression risk through the analysis of self-reported data from a large international sample of people with MS. Methods: This cross-sectional analysis recruited a total of 2459 participants via Web 2.0 platforms. Survey data included socio-demographics; a range of lifestyle risk factors; medication; disease variables and depression risk using the Patient Health Questionnaire-2 (PHQ-2). Results: In total approximately one fifth (19.3%) of our sample screened positive for depression (PHQ-2 score ≥3). Several demographic factors were significantly associated with this depression risk in bivariate analysis. Regression analyses showed that poor diet, low levels of exercise, obesity, smoking, marked social isolation and taking interferon were associated with greater depression risk. Participants who supplemented with omega 3s, particularly flaxseed oil, had frequent fish consumption, supplemented with vitamin D, meditated, and had moderate alcohol consumption had significantly reduced depression risk. Conclusions: This study demonstrates a significant association between modifiable lifestyle factors and depression risk. Planned longitudinal follow up may clarify causality. Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.
This is a free article, click below to view:
Link to Full Text