A Systematic Review of Stress-Management Interventions for Multiple Sclerosis Patients (original) (raw)
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Stress management and multiple sclerosis: a randomized controlled trial
There is a well-established adverse reciprocal relationship between stress and multiple sclerosis (MS). However, stress management in these patients has been parsimoniously studied. In this parallel randomized controlled trial, relapsing-remitting MS patients were randomly assigned to undergo either an 8-week stress management program (n = 31; relaxation breathing and progressive muscle relaxation, twice a day) or not (n = 30). Self-reported validated measures were used to evaluate perceived stress, health locus of control, anxiety, and depression. Daily diaries of MS symptoms were also kept by patients. In patients in the intervention group, perceived stress and symptoms of depression were significantly decreased after 8 weeks of relaxation. Repeated measures analyses showed significant group-by-time interactions for both the number of weekly symptoms and the mean intensity per symptom. No other significant change was reported. We deem that our results should encourage future studi...
Multiple Sclerosis Journal - Experimental, Translational and Clinical
Background Despite evidence of perceived stress as a risk factor for multiple sclerosis activity, the evidence for managing stress is limited. Objective To evaluate a stress management programme on perceived stress and quality of life, over 6 months. Methods One hundred people with multiple sclerosis were randomly assigned to either a stress management programme of mindfulness, meditation and progressive muscle relaxation, or wait list. Perceived stress and quality of life were assessed at three intervals across 6 months. Salivary cortisol levels were assessed at two intervals: baseline and first follow-up. Results The stress management programme did not significantly reduce perceived stress, when comparing mean scores. Secondary analysis using median scores found a significant improvement for quality of life, favouring the intervention group. Conclusion Stress management had no significant effect on the primary outcome of perceived stress but did improve quality of life in a second...
Stress as a Risk Factor for Multiple Sclerosis Onset or Relapse: A Systematic Review
Neuroepidemiology, 2011
and psychosocial factors in the stress-MS relationship. Also, selection and blinding problems were identified in most case-control studies. All studies, with only 2 exceptions, resulted in favor of the stress-MS relationship, but due to marked stress measurement heterogeneity, no secure conclusions could be drawn. Conclusions: Future studies should incorporate a multidisciplinary approach to stress measurement and radiological criteria for MS. We further encourage researchers to test the effect of early life stress and stress management techniques on the clinical course of the disease.
Psychology Research and Behavior Management, 2021
Purpose: Multiple sclerosis (MS) is one of the most common neurological disorders and a cause of disability in young adults. Adequate stress management in MS patients may merit the benefits of both physical and psychological well-being. This study aimed to evaluate the quality of life in MS patients and its correlation with stress levels and coping strategies. Methods: This descriptive and correlational study was conducted among 109 patients diagnosed with relapsing-remitting MS (RRMS). The study was based on a questionnaire designed by the authors and the following standardized questionnaires: the Perceived Stress Scale (PSS-10), the Inventory for Measuring Coping with Stress (Mini-COPE), and the Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL). Results: Data analysis showed that 47.71% of the patients experienced a high level of stress, and the most often used strategies under challenging situations included seeking emotional support (2.11) and active coping (1.96). Also, it showed that when the level of stress is higher, the QOL in all domains is lower. Coping strategies such as sense of humor, turning to religion, self-distraction, denial, venting, substance use, behavioral disengagement, and selfblame are negatively correlated with the quality of life of MS. Conclusion: Quality of life in MS patients is negatively affected by a higher level of perceived stress. The use of coping strategies such as active coping, positive reframing, acceptance, and seeking emotional and instrumental support is positively correlated with the quality of life of MS patients.
A Psychoeducation Program for Stress Management and Psychosocial Problems in Multiple Sclerosis
2020
Background: Multiple Sclerosis (MS) patients should cope effectively with problems of life and with problems originating from the disease. This is important because it affects the course of the disease, psychiatric morbidity, and quality of life. Objective: This study was carried out as an intervention design with a control group to assess the effects of psychoeducation on MS patients’ ways of coping with stress, psychiatric symptoms, and qualities of life. Subjects and Methods: A total of 80 MS patients affiliated with the MS Association of Turkey were included and randomly assigned into intervention and control groups. An 8‑week psychoeducation program was offered to the intervention group, whereas the control group was not given any treatment during the same period. Data were collected using a Descriptive Information Form, the Ways of Coping Inventory, the Brief Symptom Inventory, and the MS Quality of Life‑54 scale. Results: Based on the study, among the ways of coping with stress, problem‑focused approach increased, whereas the emotional‑focused approach decreased statistically significantly in the intervention group. Among the psychiatric symptoms, the levels of anxiety, depression, and somatization decreased. However, there was no significant change in the negative self‑concept and hostility symptoms. The total quality‑of‑life scores increased significantly (P < 0.05). In the intervention group, these effects continued in the three‑month‑follow‑up measurement. The control group showed no statistically significant change in the same parameters during the same periods. It is recommended that group psychoeducation programs should be carried out extensively in order for MS patients to cope with stress effectively and improve their mental health and quality of life
Journal of Occupational Health and Epidemiology, 2016
Background: Multiple sclerosis (MS) is one of the most common chronic diseases of the central nervous system. The aim of this study was to determine the effectiveness of psychological training combined with gradual muscular stress relaxation technique on QOL of patients with MS. Materials and Methods: This triple-blind, controlled, clinical trial was conducted on 60 patients with MS who were members of the Multiple Sclerosis Society of Yazd Province, Iran. The subjects were selected through convenience sampling method and with the consideration of the inclusion criteria. The participants were randomly divided into 2 groups of experimental (30 persons) and control (30 persons). The experimental group received 12 sessions of psychological training combined with gradual muscular stress relaxation technique (2 sessions per week), but the control group received no intervention. The data collection tools used consisted of a demographic characteristics form and the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire. The questionnaires were completed before, immediately after, and 3 months after the training. Data were analyzed using the statistical tests of student's t-test, Pearson correlation, and repeated measures.
Perceived Stress in Multiple Sclerosis
Journal of Evidence-Based Complementary & Alternative Medicine, 2014
Stressful life events are associated with worsening neurological symptoms and decreased quality of life in multiple sclerosis (MS). Mindful-consciousness can alter the impact of stressful events and has potential to improve health outcomes in MS. This study evaluated the relationship between trait mindfulness and perceived stress, coping, and resilience in people with MS. Quality of life was assessed as a secondary outcome. 119 people with confirmed MS completed the Fivefacet Mindfulness Questionnaire, Perceived Stress Scale, Brief Coping Orientation for Problem Experiences, Connor-Davidson Resilience Scale, and the SF-36. Greater trait mindfulness was significantly associated with decreased psychological stress, better coping skills, increased resilience, and higher quality of life. After controlling for confounders, mindfulness accounted for 25% of the variation in perceived stress scores and 44% of the variation in resilience scores. Results support further investigation of mindfulness training to enhance psychological resilience and improve wellbeing for those living with MS.
Multiple Sclerosis, 2006
Objective The aim of this two-year prospective study was to examine the relationship between multiple aspects of life-event stress and relapse in multiple sclerosis (MS) patients. Background Few studies have defined the critical features of this life-event stress; for example, stressor duration, frequency, severity, disease-dependency, valency, or stressor constructs, such as the propensity to cause emotional distress/threat or the frustration of life goals. Methods 101 consecutive participants with MS were recruited from two MS clinics in Sydney, Australia. Stressful life events were assessed at study-entry and at three-monthly intervals for two years. Patient-reported relapses were recorded and corroborated by neurologists or evaluated against accepted relapse criteria. Results Acute events, but not chronic difficulties (CDs), predicted relapse occurrence: acute stressor frequency counts predicted greater relapse risk, along with low disability score (EDSS) and being male. We also confirmed the bi-directional stress-illness hypothesis: stressors predicted relapse, and relapse separately predicted stressors. Conclusions Life-event stress impacts to a small degree on MS relapse. The number and not the severity of acute stressors are most important; chronic stressors do not predict later relapse. Males and those with early stage disease are also at greater risk of relapse. MS patients should be encouraged to reduce acute stressors during times of high stress, and feel reassured that diseaserelated chronic stressors do not increase their relapse risk. Multiple Sclerosis 2006; 12: 453 Á 464. www.multiplesclerosisjournal.com
The coping methods for stress of multiple sclerosis patients and the related psychiatric symptoms
J Psychiatric Nurs, 2019
Objectives: This study aims to describe the ways that multiple sclerosis (MS) patients cope with stress in their lives and to evaluate symptoms of psychiatric problems. Methods: The sample was chosen from 245 MS patients who are registered with the Multiple Sclerosis Association Turkey, Ankara Office and agreed to participate in the study. Data were collected by administering an introductory information form, Ways of Coping Inventory (WCI) and the Brief Symptom Inventory (BSI). Results: Patients with MS were more likely to use problem-oriented approaches in coping and most experienced depression and hostility as psychiatric disorders. There was a positive correlation between the helpless approach in the emotional-oriented approach and psychiatric symptoms. Conclusion: MS patients should be considered to be at risk for psychiatric disorders. Effective coping strategies that reduce the use of the helpless approach for coping with stress should be supported in terms of preventive mental health.
Stress differentially predicts multiple sclerosis relapses
2014
Background and Objective: For decades, stress has been postulated as a risk factor for multiple sclerosis (MS) relapses. Because of conflicting results in previous studies we conducted a prospective study to investigate this relationship in a less studied, Middle Eastern population. Methods: In this prospective study, 57 Iranian MS patients were followed trimonthly for 12 months. Possible stressful events (measured with validated Persian version of Paykel’s questionnaire) and quality of life (measured with validated Persian version of the Multiple Sclerosis Impact Scale questionnaire) were assessed in successive visits in addition to other variables. Relapses were enquired and confirmed clinically by a Neurologist. Main analysis was done by use of Mixed Generalized Linear Model. Results: Mean age of the participants was 33.5±7.4 years, 81% were females, and all were receiving interferons. Number of stressors, not the stress severity measures, reached near significance in predicting ...