People diagnosed with multiple sclerosis (MS) who also are depressed are more likely to suffer debilitating symptoms early than people with MS who are not depressed, according to a new study.
Researchers at the Karolinska Institutet in Sweden say their findings highlight the need for early recognition and treatment of depression in patients with MS.
More than 2 million people around the world have MS, a disease that often impairs the ability to walk and move.
It is known that depression is a risk factor for MS and that depression is more common in people with MS, the researchers noted. What has been uncertain, however, is if depression can also be linked to the rate of MS progression, they said.
For the study, researchers compared the course of the disease in nearly 1,800 MS patients who were depressed with that of some 7,900 MS patients who were not depressed over a period of up to 13 years.
They found that depressed MS patients had an almost 90 percent higher risk of reaching a state where they needed a cane to walk 100 meters than those who were not depressed.
This was also true for patients who were diagnosed with depression before their MS onset, which suggests that MS in itself is not necessarily the cause of the depression, according to the researchers.
“We cannot with certainty determine the causality, but it is interesting that the risk for disability worsening was higher…in people who were depressed already before they were diagnosed with MS,” said Dr. Stefanie Binzer, a researcher at the Department of Clinical Neuroscience at Karolinska Institutet and corresponding author.
The researchers also found that MS patients with depression are more likely to smoke and are more inclined to neglect taking their medications.
Depressed people are also less eager to exercise, and a lack of physical activity could lead to a more rapid deterioration, the researchers noted.
It is also possible that depression and MS have shared disease mechanisms that enhance each other, the researchers said. In that case, treatment of depression is a particularly important part of MS care. More research is needed to determine the causality between depression and MS worsening, researchers added.
“Our study indicates that it may be very important to pay attention to depressive symptoms in people with MS and to begin treatment early,” said Dr. Jan Hillert, a professor at the Department of Clinical Neuroscience at Karolinska Institutet and another of the study’s authors. “Further research is needed to examine whether antidepressant treatment has the potential to minimize MS disability.”
The study was published in the journal Neurology.
Source: Karolinska Institutet