Impact of exposure to war stress on exacerbations of multiple sclerosis
Article first published online: 20 JUN 2008
Copyright © 2008 American Neurological Association
Annals of Neurology
Volume 64, Issue 2, pages 143–148, August 2008
How to Cite
Golan, D., Somer, E., Dishon, S., Cuzin-Disegni, L. and Miller, A. (2008), Impact of exposure to war stress on exacerbations of multiple sclerosis. Ann Neurol., 64: 143–148. doi: 10.1002/ana.21409
- Issue published online: 28 AUG 2008
- Article first published online: 20 JUN 2008
- Manuscript Accepted: 21 MAR 2008
- Manuscript Revised: 3 MAR 2008
- Manuscript Received: 30 NOV 2007
- Trauma & Military Medicine Research fund, Technion. Grant Number: 200915
To assess the relation between stress caused by the perils of rocket attack on civilian centers in northern Israel during the 2006 war between Hezbollah and Israel and multiple sclerosis (MS) exacerbations.
Participants were 156 patients with relapsing-remitting MS. We compared the number of relapses during and after the war with similar time periods at the preceding year. Exposure to war events and resulting subjective stress were evaluated by means of structured interviews using questionnaires previously validated.
During the 33 days of the war, there were 18 relapses among our patients, compared with 1 to 6 relapses in similar time periods over the 12 months before the war (p < 0.001–0.02). There was no increase in relapse rate during the 3 months that followed the war (p = 0.58). The percentage of patients reporting the experience of intense subjective stress during the hostilities was significantly greater among patients with wartime relapse compared with the rest of the patients (44 vs 20%). The proportion of patients reporting high levels of distress associated with exposure to rocket attacks, displacement from home, and perceived life threat was greater in relapsing patients compared with those in remission (67 vs 42%, p = 0.05; 33 vs 11%, p = 0.02; and 33 vs 15%, p = 0.08, respectively).
Our data suggest that civilian exposure to war stress is associated with increased risk for MS relapse. These findings provide insight to stress-related risk factors associated with relapses of MS. Ann Neurol 2008