Briones-Buixassa Laia, Milà Raimon, Mª Aragonès Josep, Bufill Enric, Olaya Beatriz, Arrufat Francesc Xavier
Centre d'Estudis Sanitaris i Socials (CESS),Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Spain.
Consorci Hospitalari de Vic, Spain.
Health Psychol Open. 2015 Nov 4;2(2):2055102915612271. doi: 10.1177/2055102915612271. eCollection 2015 Jul.
Research about the effects of stress on multiple sclerosis has yielded contradictory results. This study aims to systematically review the evidence focusing on two possible causes: the role of stress assessment and potential moderating and mediating factors. The Web of Knowledge (MEDLINE and Web of Science), Scopus, and PsycINFO databases were searched for relevant articles published from 1900 through December 2014 using the terms "stress*" AND "multiple sclerosis." Twenty-three articles were included. Studies focused on the effect of stress on multiple sclerosis onset ( = 9) were mostly retrospective, and semi-structured interviews and scales yielded the most consistent associations. Studies focused on multiple sclerosis progression ( = 14) were mostly prospective, and self-reported diaries yielded the most consistent results. The most important modifying factors were stressor duration, severity, and frequency; cardiovascular reactivity and heart rate; and social support and escitalopram intake. Future studies should consider the use of prospective design with self-reported evaluations and the study of moderators and mediators related to amount of stress and autonomic nervous system reactivity to determine the effects of stress on multiple sclerosis.
关于压力对多发性硬化症影响的研究得出了相互矛盾的结果。本研究旨在系统回顾聚焦于两个可能原因的证据：压力评估的作用以及潜在的调节和中介因素。使用“stress*”和“multiple sclerosis”这两个检索词，在知识网络（MEDLINE和科学网）、Scopus以及PsycINFO数据库中搜索了1900年至2014年12月期间发表的相关文章。共纳入23篇文章。聚焦于压力对多发性硬化症发病影响的研究（n = 9）大多为回顾性研究，半结构化访谈和量表得出的关联最为一致。聚焦于多发性硬化症进展的研究（n = 14）大多为前瞻性研究，自我报告的日记得出的结果最为一致。最重要的调节因素是应激源的持续时间、严重程度和频率；心血管反应性和心率；以及社会支持和艾司西酞普兰的摄入。未来的研究应考虑采用自我报告评估的前瞻性设计，并研究与压力量和自主神经系统反应性相关的调节因素和中介因素，以确定压力对多发性硬化症的影响。
