Investigating the Link Between Anxiety and Multiple Sclerosis: A Review

Abstract

Abstract Background Nearly one billion people worldwide have a mental disorder. During the last few years, the number of people suffering from psychological disorders such as depression and anxiety has increased by more than 25%. Just over 22% of multiple sclerosis (MS) patients experience anxiety. MS is an autoimmune disorder of the central nervous system (CNS) that is characterized by a complex interplay of factors, leading to inflammation, demyelination, and neurodegeneration. The disease strikes more people every year with no definitive aetiology. Many genetic, infectious, and environmental factors were confirmed as MS risk factors, but no psychological factors have been considered. Objective This review aims to explore the effect of anxiety on the manifestation of MS, the correlation between anxiety and MS symptomology, and possible connection points between anxiety and MS. Method A literature search was conducted in the NCBI PubMed database to investigate the impact of anxiety on MS symptomology and episodes, as well as any possible link between anxiety and MS. The search was conducted up to October 2022. Results Database searches retrieved a total of 1,607 articles for the phrase ‘multiple sclerosis and anxiety’ published from 1964 to 2022. Data were thoroughly reviewed to include only statistically significant associations. Several articles reported strong associations between anxiety and MS symptoms and episodes. Despite the lack of articles exploring the relationship between anxiety and MS, several pointed to the negative effect of anxiety on the immune system. The fact that MS is an autoimmune disorder of the CNS, and that anxiety dysregulates immunity, could indicate that anxiety has an effect on MS. Prospective: Further studies must be undertaken to understand the influence of anxiety on MS; meanwhile, psychological evaluation of MS patients is strongly recommended and needs to be incorporated into treatment plans.