Zur Beziehung von psychologischem Stress und klinischem Verlauf der multiplen Sklerose

 

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Zusammenfassung

Der Zusammenhang zwischen psychologischem Stress und Verlauf der MS ist in zahlreichen Studien mit unterschiedlicher methodischer Qualität untersucht worden. Die Mehrheit der Befunde deutet darauf hin, dass ein akuter, kurzfristiger Stressor keine negativen Auswirkungen hat. Dagegen sind chronische psychosoziale Stressoren wie interpersonale Konflikte, unverarbeitete Verlusterlebnisse, subjektiv empfundener Mangel an sozialer Unterstützung, Ängste und depressive Episoden als mögliche schubfördernde Risikofaktoren anzusehen. Die neuroimmunologischen Befunde bei der MS und verschiedenen Stressbedingungen werden unter besonderer Berücksichtigung der Veränderungen des Lymphozyten- und Zytokinnetzwerks dargestellt und nach ihrer möglichen klinischen Bedeutung gewichtet. Praktische Konsequenzen für psychologische Interventionsstrategien werden zur Diskussion gestellt.

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.

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Priv.-Doz. Dr. med. Hans Strenge

Institut für Medizinische Psychologie

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