Evidence map›Paper›PMID 15033880›Full record

SynthesisBMJ (Clinical research ed.)2004

Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis.

David C Mohr, Stacey L Hart, Laura Julian, Darcy Cox, Daniel Pelletier

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

122 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  8. Article
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  10. Self-mastery buffers associations between stressful life events and mental quality of life and fatigue in people living with multiple sclerosis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
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  14. Observational
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62 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

David C MohrDepartment of Psychiatry, University of California, San Francisco, CA 94142, USA. dmohr@itsa.ucsf.edu
Stacey L Hart
Laura Julian
Darcy Cox
Daniel Pelletier

Funding

A Controlled Trial of CBT for Multiple Sclerosis InflammationR01HD043323 · NICHD · NORTHERN CALIFORNIA INSTITUTE RES &EDUC · PI DAIKH, DAVID I · 2003 to 2010
$7.3M
Telephone Versus Face-to-Face Administration of CBT for DepressionR01MH059708 · NIMH · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI MOHR, DAVID CURTIS · 2000 to 2011
$7.2M
NICHD NIH HHS R01 HD043323-01NIMH NIH HHS R01 MH59708-01
6 · The paper itself

Abstract

objectiveTo quantify the association between stressful life events and exacerbations of multiple sclerosis. DATA SOURCES: PubMed, PsychInfo, and Psychological Abstracts searched for empirical papers from 1965 to February 2003 with terms "stress", "trauma", and "multiple sclerosis". REVIEW

methodsThree investigators independently reviewed papers for inclusion/exclusion criteria and extracted the relevant data, including methods, sample statistics, and outcomes.

resultsOf 20 studies identified, 14 were included. The meta-analysis showed a significant increase in risk of exacerbation in multiple sclerosis after stressful life events, with a weighted average effect size of d = 0.53 (95% confidence interval 0.40 to 0.65), P < 0.0001. The studies were homogenous, Q = 16.62, P = 0.22, I2 = 21.8%. Neither sampling nor study methods had any effect on study outcomes.

conclusionsThere is a consistent association between stressful life events and subsequent exacerbation in multiple sclerosis. However these data do not allow the linking of specific stressors to exacerbations nor should they be used to infer that patients are responsible for their exacerbations. Investigation of the psychological, neuroendocrine, and immune mediators of stressful life events on exacerbation may lead to new behavioural and pharmacological strategies targeting potential links between stress and exacerbation.

Indexed as

Life Change EventsHumansMultiple SclerosisRisk FactorsStress, PsychologicalTreatment Outcome

Identifiers

PMID15033880
PMCPMC381319

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.