The relationship between psychological stress and the clinical course of multiple sclerosis. An update

The relationship between psychological stress and the course of MS has been investigated in several studies using methods with different qualities. The majority of findings indicates that acute short-term stressors have no negative consequences. Chronic psychosocial stressors, however, such as interpersonal conflicts, loss and complicated bereavement, low perceived social support, anxiety and depressive episodes have to be regarded as possible risk factors for the development of MS exacerbations. The neuroimmunological findings in MS and under various stress conditions are delineated with emphasis on the changes in lymphocyte and cytokine networks and evaluated with regard to their possible clinical significance, Practical consequences for psychological intervention strategies are discussed.