Lifestyle factors like exercise, meditation, and alcohol use were inversely associated with depression risk, while smoking significantly predicted depression.
Depression is common among patients with multiple sclerosis (MS), with half of people with MS having an episode of depression in their lifetime. However, the evidence base for treating depression in this population is limited. A new study in Frontiers in Psychiatry analyzed the relationship between modifiable lifestyle factors and depression risk, as well as the change in depression over 2.5 years.
The researchers studied 2224 patients at baseline and 1309 patients at the 2.5 year follow up who completed survey data. Depression risk was measured by the Patient Health Questionnaire-2 (PHQ-2) at baseline and by the Patient Health Questionnaire-9 (PHQ-9) at the 2.5-year follow up. In PHQ-2, scores range from 0 to 6, with scores >2 indicating a positive depression score. In PHQ-9, scores range from 0 to 27, with scores >9 indication a positive depression score.
“An emerging paradigm which provides a nexus between prevention, health promotion and clinical treatment of depression, is modification of known lifestyle risk factors for depression,” the authors explained. “In the general population, prospective studies in teenagers and adults showed that modification of lifestyle factors, including diet, exercise, weight and smoking, improved and prevented depression.”
The researchers collected data on sociodemographics and biometrics (eg, sex, age, height, weight, country of birth and residence, marital status, education level, and employment), dietary habits, vitamin D supplementation, omega-3 supplementation, exercise, meditation, alcohol consumption, and smoking behavior.
Among the patients who completed PHQ-2 at baseline, the prevalence of depression was 14.5% compared with 21.7% among those who completed PHQ-9 at the follow up.
Being a current smoker was significantly predictive of depression, while alcohol consumption was associated with a lower risk of becoming depressed and even a higher likelihood of losing depression (screening positive for depression at baseline and losing this at follow-up).
Vitamin D and omega-3 supplementation were also associated with less depression risk. Physical activity and meditation were both associated with significantly reduced prevalence of depression. In addition, patients with MS who meditated at least weekly reported a higher likelihood of losing depression.
“These results, if confirmed, suggest that some healthy lifestyle behaviors may positively impact depression risk among people living with MS,” they concluded.
Taylor KL, Simpson S Jr, Jelinek GA, et al. Longitudinal associations of modifiable lifestyle factors with positive depression-screen over 2.5-years in an international cohort of people living with multiple sclerosis. Front Psychiatry. 2018 Oct 30;9:526. doi: 10.3389/fpsyt.2018.00526.