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Lifestyle factors contribute to depression in patients with MS

Modifiable lifestyle factors contribute to depression in multiple sclerosis (MS) patients, according to a study published in BMC Psychiatry.

Researchers from St. Vincent's Hospital Melbourne in Victoria, Australia examined nearly 2,500 MS patients in order to understand the association between lifestyle risk factors, medication, and depression risk through the analysis of self reported data. The researchers collected data about the participants' sociodemographics, diagnostic history, level of disability, comorbidities, fatigue, depression, body mass index (BMI), and an assortment of lifestyle and health behaviors. Patients were mainly female (82.4 percent) and middle aged (median age 45 years) and most patients (61.3 percent) had relapsing remitting MS. Most participants health either a bachelor (36.5 percent) or post graduate degrees (23.5 percent) and worked either full time (32.8 percent) or part time (21.3 percent). Diagnosis occurred at a median age of 37 years and half (45.2 percent) had been recently diagnosed within the last 5 years. Mild disability was reported in 54.8 percent of the patients..... Read more - http://www.ms-uk.org/qol

I read this summary of some research (would have been nice to know who the authors were) with eyes that opened ever wider.
I know that SE Australia has a high incidence of MS, but 500 times more than UK? This I do not believe!
The reported (transcribed) incidence is also way (way, way, way) higher than New Zealand, and Iceland (both also countries known for high MS incidence).
So, given one glaring mistake in transcribing and summarizing the report, can the rest of it be trusted to be accurate?

In a way, this looks like something from the work of David Bakan - who showed that if you have a large enough sample you can always find something that is statistically significant.
Of course, depression is probably the most studied of the mental health conditions, and the summary betrays a total lack of knowledge of depression. Don't take my word for it, read Bebbington et al (1988).
G

Here's the complete paper, it is open access:
http://www.biomedcentral.com/1471-244X/14/327

There is nothing in the summary above or paper regarding MS incidence in Australia. It appears to be a well-conducted study, which recruited over 2459 MS patients to self-report. Thanks to Dr. George Jelinek for his continued work.

This study demonstrates a strong clinically and statistically significant association between modifiable lifestyle factors and risk of depression. Diet, smoking, exercise, omega 3 supplementation, (particularly flaxseed oil), fish consumption, social support, vitamin D supplementation, BMI, alcohol intake, meditation and choice of medication are important modifiable factors in depression risk for people with MS. It is important for clinicians and people with MS to 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.

As far as limitations of the study---this is a very valid point....

Reverse causality may contribute to these associations as depression may result in less healthy behaviours, such as being sedentary, eating badly, and smoking, perhaps through low motivation. However, the dose-response effect for many of the lifestyle variables, and the biological plausibility of the associations, reduce the likelihood of reverse causality playing a major role in these findings. Planned longitudinal follow up of participants may help clarify causality.

Participants self-reported data so the potential for measurement error such as recall bias exists, as well as potential for this error to be correlated between the exposures and outcomes (dependent misclassification) thus biasing results. The degree to which this is a problem in our data is not known.

It will never be possible to placebo control a complete lifestyle, but that doesn't mean lifestyle changes can't be beneficial. I live with anecdotal proof. Daily exercise, daily UV rays, whole food nutrition, staying trim, consuming fish (omega 3 oil), limited alcohol, no smoking, meditation, social support---all have helped my husband stay active, depression free, and MS progression free at 51 yrs. of age.
Dr. Jelinek has some helpful advice, which comes from losing his mother to MS and the being dx w/MS in 1999. He walks the walk.
http://www.overcomingmultiplesclerosis. ... r-Jelinek/


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