HOLISM study shows lifestyle factors key to depression in MS

The latest publication from the HOLISM study examined the association of lifestyle factors, medications and the characteristics of PwMS with their risk of depression.

Evidence supports the OMS Program

As with the other HOLISM papers, the results strongly support the OMS Recovery Program. Essentially, of 2,225 PwMS from 54 different countries worldwide, those with the highest risk of depression were those with the worst dietary habits, those who smoked, the socially isolated, and those who were overweight.

Categorising diet into four groups from best (very low saturated fat consumption, high fruit and vegetable consumption) through to the worst (high saturated fat, processed food consumption), those in the worst group had nearly five times higher risk of depression than those in the best dietary habits group.

Smokers had three and a half times higher risk than non-smokers, and PwMS who were obese had about twice the risk of depression as those of normal weight.

Factors protecting against depression

Factors protecting against depression were exercise (those with high levels of exercise had about one third of the risk of those with low levels of exercise), eating fish more frequently (eating fish three times or more a week was associated with one third the risk of depression compared with eating fish less than once a week).

Vitamin D supplementation (taking any vitamin D supplements was associated with around half the risk of depression compared with taking none), omega 3 supplementation (flaxseed oil associated with one third the risk, and fish oil with half the risk of depression, compared with those not taking omega 3s).

Moderate alcohol intake (reducing the risk 50% compared with low alcohol intake), and meditation (meditating only once a week or more halving the risk compared with not meditating).

Interestingly, those taking interferon had roughly 60% higher risk of depression than those not taking a disease-modifying drug, whereas there was no increased risk of depression with the other medications.

This is ground-breaking research. The study, led by psychiatrist Dr Keryn Taylor, who facilitates OMS retreats in Australia and the United Kingdom, is sure to influence the management of PwMS globally.

Depression risks

It has been common practice to accept that PwMS are at much higher risk of depression than other people, and begin treatment with anti-depressants should a person with MS get depressed.

This research opens up the important avenue of prevention; attending to these modifiable lifestyle risk factors raises the possibility of avoiding depression in the first place.

Fortunately, the very same risk factors have been previously shown in the HOLISM study to also be associated with better quality of life, and reduced disease activity.

This latest research adds strong evidence for the potential benefits of a preventive medicine strategy to achieve the best outcomes for PwMS.

The paper was the 'Editor's Pick' of the papers published in BMC Psychiatry this week! The MS Society of the United Kingdom, in a blog on the BMC Journal website, described the research as 'crucial.

Reference

► Taylor KL, Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. Lifestyle factors, medications and demographics associated with depression risk in an international sample of people with multiple sclerosis. BMC Psych 2014;14:327 View pdf