Depression and Anxiety May Be Early Signs of MS

In the years before the beginning of multiple sclerosis (MS), patients were nearly twice as likely to develop mental illness.

The study, conducted by the University of British Columbia and published in the official journal Neurology, raises the possibility that mental illnesses like depression and anxiety could be a component of the prodromal phase of multiple sclerosis (MS), which is characterized by a combination of early symptoms and signals that appear before characteristic MS symptoms.

According to senior author, Helen Tremlett from UBC, MS was long believed to manifest only clinically after a person experienced their first demyelinating event, such as visual issues.

But we've come to understand there is a whole period preceding those events where the disease presents itself in more indirect ways.

- Tremlett

What is MS?

Myelin, the protective sheath that protects nerve fibers, is attacked by the immune system in MS, an inflammatory condition that impairs brain communication. Medical practitioners frequently struggle to identify MS because of its many symptoms and the ease with which they can be confused with those of other diseases.

This implies that the road to a diagnosis can be arduous and unpredictable for many people. To facilitate earlier detection and potential management, Tremlett and her team have been striving to characterize the early phases of MS better.

It is well known that some diseases, including Parkinson's, have prodromal stages during which people have symptoms like constipation years before the onset of traditional motor deficits.

She continues by saying that earlier diagnosis and treatment of MS would be possible. That has a great chance of slowing illness progression and enhancing people's quality of life.

Behind the team's study

The study included 6,863 MS patients in British Columbia who had their health data evaluated by researchers. In the five years before patients manifested the traditional, medically recognized symptoms of MS, researchers examined the frequency of mental health problems such as depression, anxiety, bipolar disorder, and schizophrenia.

Thirty-one thousand eight hundred sixty-five patients without MS were compared to these MS patients. The results showed that, at 28% and 14.9%, MS patients had mental disorders at approximately twice the rate of the general population.

Patients with MS also frequently use healthcare services for psychiatric symptoms, including hospitalizations, medicines, and visits to doctors and psychiatrists. Notably, the difference grew in each of the five years before the commencement of the disease.

Anibal Chertcoff, the study's first author, explained that rates of mental illnesses rise steadily and peak in the year before the onset of MS.

"While we're not suggesting that these conditions alone can predict MS, they may be one piece of the MS prodrome puzzle and a potential signal when combined with other factors," said Chertcoff.

The research expands on earlier findings from Tremlett's group, suggesting that the MS prodrome may also include other symptoms like exhaustion, sleep issues, irritable bowel syndrome, anemia, and pain. Sharon Roman, who has had MS for 25 years, believes patients would greatly benefit from a more precise definition of the prodromal stage.

Roman said: "The better we can identify the early signs and symptoms of MS, the earlier we can recognize, diagnose and treat it. We can help prevent people from being diagnosed the way I was, with a massive attack and hospitalization, and prevent the losses I've experienced. Earlier treatment may help slow progression."

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