magoo wrote:Dr. Sclafani,
Can you explain why people who have had treatment sometimes have a return of old symptoms when sick? The people I have talked with about this say it is to a lesser degree. I am included in this group because I have had more headaches and stiffness when I am sick, which resolves when I am well again. But this does seem to cause anxiety. Is there any way you can explain this to ease our minds?
rhonda, such a nice surprise for you to ask a question. And you ask a good one. i am not sure that "illness" brings on old symptoms when sick. perhaps it is the stress? I will look around.
if illness leads to stress???:
Psychosomatic Medicine 64:916-920 (2002)
© 2002 American Psychosomatic Society
Stressful Life Events Precede Exacerbations of Multiple Sclerosis
Kurt D. Ackerman, MD, PhD, Rock Heyman, MD, Bruce S. Rabin, MD, PhD, Barbara P. Anderson, PhD, Patricia R. Houck, MSH, Ellen Frank, PhD and Andrew Baum, PhD
From the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania.
Address reprint requests to: Kurt D. Ackerman, MD, PhD, Western Psychiatric Institute and Clinic, 3811 O’Hara St., Pittsburgh, PA 15213. Email: firstname.lastname@example.org
OBJECTIVE: We longitudinally monitored life events and health changes in patients with multiple sclerosis (MS) to determine whether stressful events may trigger exacerbation of MS.
METHODS: Twenty-three women with MS were followed for 1 year. Each subject completed the Psychiatric Epidemiologic Research Interview on a weekly basis. Further information on potentially stressful events was acquired using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored on a weekly basis throughout the year. Potential MS exacerbations were confirmed by a neurologist who was blind to the presence and timing of stressors.
RESULTS: Eighty-five percent of MS exacerbations were associated with stressful life events in the preceding 6 weeks. Stressful life events occurred an average of 14 days before MS exacerbations, compared with 33 days before a randomly selected control date (p < .0001). Survival analysis confirmed that an increase in frequency of life events was associated with greater likelihood of MS exacerbations (hazard ratio = 13.18, p < .05).
CONCLUSIONS: These results are consistent with the hypothesis that stress is a potential trigger of disease activity in patients with relapsing-remitting MS.