Stress and exacerbations in multiple sclerosis

doi:10.1136/bmj.328.7434.287-a

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Authors' reply

R Q Hintzen, neurologist (rhintzen@xs4all.nl),
D Buljevac, medical doctor,
W C J Hop, biostatistician,
A C J W Janssens, psychologist

Department of Neurology, Erasmus MC, Postbox 2040, 3000 CA Rotterdam, Netherlands
Department of Epidemiology and Biostatistics, Erasmus MC
Department of Medical Psychology and Psychotherapy, Erasmus MC

EDITOR—We agree with Galea et al that recall bias could be an alternative explanation for our finding that stressful events are associated with the risk of exacerbation in multiple sclerosis.

To minimise the possibility of recall bias we chose a high (weekly) sampling frequency. Nevertheless, when patients experienced an event and still had …