MS and depression can be deadly mix, study says

It's a significant finding because depression is a common symptom of multiple sclerosis.

Dave Yasvinski 4 minute read September 3, 2021
MS depression

Depression, a common symptom of multiple sclerosis, can be harmful. GETTY

People who suffer from both multiple sclerosis and depression appear to live shorter lives those with just one condition, according to a new study.

The research, published in the journal Neurology, said the chronic autoimmune disease can combine with the mood disorder to produce a “synergistic effect” that also raises the risk of vascular disease. “These findings underscore the importance of identifying depression in people with MS as well as monitoring for other risk factors for heart disease and stroke,” said Raffaele Palladino, author of the study at Imperial College of London in the U.K.

“Future studies need to be conducted to look at whether treating depression in people with MS could reduce the risk of vascular disease as well as death over time.”

Canada has one of the highest rates of multiple sclerosis in the world, with 1 in 400 — or over 900,000 people — living with the disease, according to the MS Society. There are roughly 2.8 million people suffering from MS globally, with prevalence having increased in every area of the world since 2013. The unpredictable disease attacks the body’s myelin — the layer of insulation protecting nerves — causing inflammation and disrupting nerve impulses throughout the central nervous system. Depending on the area of attack, the disease can lead to a wide range of symptoms, including diminished vision, memory, balance and mobility, to name a few.

Depression is one of the most common symptoms of multiple sclerosis, with previous research suggesting the lifetime prevalence of the mood disorder to be as high as 50 per cent in MS patients. Untreated, depression can decrease quality of life and exacerbate other symptoms, including fatigue, pain and cognitive changes.

For the study, researchers identified 12,251 people with MS and 75,572 without; 21 per cent of MS patients had depression at the outset of observation, compared to 9 per cent in the non-MS group. They consulted 10 years of medical records to determine the occurrence of vascular disease over the course of study.

Patients with both MS and depression were found to have a mortality rate from any cause of 10.3 cases per 100,000 person-years (a measure used because it encompasses the number of people — and length of time — in the study). The mortality rate for people with MS but no depression was 10.6; for people with depression but not MS, it was 3.6; and for those with neither, it was 2.5.

Once accounting for other variables influencing risk of death, such as diabetes and smoking, researchers found that people with MS and depression were more than five times more likely to die over the next 10 years than those without either condition. Those with MS but not depression were nearly four times more likely to die over the same period and those with depression but not MS faced twice the risk of death than those without either condition. People with MS and depression were also three times more likely to develop vascular disease than people with neither condition.

The study was limited by a lack of information on the body mass index of patients — a factor than can affect both vascular disease and death — but the findings were significant enough for researchers to sound the alarm on the growing risk of the convergence of two serious health issues. “When we looked at the risk of death, we found that the joint effect of MS plus depression equalled more than the effect for each individual factor alone — in other words, the two conditions had a synergistic effect,” Palladino said.

“A total of 14 per cent of the effect on mortality rate could be attributed to the interaction between these two conditions.”

For more information on MS, support or to connect with other patients, visit the Multiple Sclerosis Society of Canada.

Dave Yasvinski is a writer with