- A tailored cognitive behavioural therapy intervention helped reduce depression symptoms in people newly diagnosed with MS.
- Participants receiving the therapy were more likely to have a clinically meaningful improvement in depression than those receiving supportive listening therapy.
- Improvements were also seen in anxiety, pain impact, sleep quality, quality of life, acceptance of MS and some cognitive measures.
What was the aim of the research?
Depression and anxiety are common in people with MS, particularly around the time of diagnosis. Cognitive behavioural therapy (CBT) can help some people with MS manage depression by supporting them to change unhelpful patterns of thinking and behaviour. However, few CBT programs have been designed specifically for people in the early stages after an MS diagnosis.
This study aimed to test whether a tailored CBT program, called ACTION-MS, could reduce mild to moderate depression symptoms in people recently diagnosed with MS, compared with a supportive listening intervention.
What did the researchers do?
The study, published in the Journal of Affective Disorders, was led by Associate Professor Litza Kiropoulos and colleagues and was supported by MS Australia Project Grant funding. The researchers recruited 60 adults from four MS centres in metropolitan Melbourne. Participants had a neurologist-confirmed diagnosis of relapsing-remitting MS, had been diagnosed within the previous five years, and had mild to moderate depressive symptoms.
Participants were randomly assigned to receive either the tailored ACTION-MS CBT program or supportive listening. Both interventions were delivered by clinical or provisional psychologists in weekly 60-minute sessions over eight weeks. Participants completed assessments at the start of the study, at the end of the eight-week intervention and again at week 28 to see whether any changes were maintained.
What did the study find?
The study found that participants who received the tailored CBT program were more likely to experience a reduction in depressive symptoms than those who received supportive listening. At the end of the eight-week intervention, 63.3% of participants in the CBT group had a clinically meaningful improvement in depression compared with 33.3% in the supportive listening group. This improvement was demonstrated by a reduction of at least 10 points on the depression severity scale, enough to move participants into a lower symptom severity category.
Participants in the CBT group also reported lower depression scores at week 28, suggesting that treatment benefits were maintained several months after the intervention.
The researchers also found that the tailored CBT program was associated with improvements in anxiety, pain impact, sleep quality, quality of life, problem-solving, coping and acceptance of MS. Some cognitive benefits were also reported, including improvements in processing speed, sustained attention and the ability to remember visual information.
What does this mean for people with MS?
Depression and anxiety can affect a person’s quality of life, their ability to manage MS symptoms and their overall wellbeing. The study findings support the use of tailored CBT early after diagnosis to help treat mild to moderate depressive symptoms in people with relapsing-remitting MS.
The findings are particularly encouraging because the ACTION-MS program was designed specifically for people with MS. It addressed depression as well as MS-related issues such as pain, fatigue, sleep, coping and acceptance of living with MS.
For people newly diagnosed with MS who are experiencing low mood or anxiety, the study highlights the importance of discussing mental health concerns with their healthcare team. Psychological support, including CBT-based approaches, may be an important part of early MS care.
MS Australia is supporting further work in this area through ACTION-MS online, a modified web-based version of the original in-person ACTION-MS program. Developed by Associate Professor Kiropoulos and her team, the online program aims to make tailored depression support more accessible for people with MS, particularly those who may find it difficult to attend face-to-face appointments.
The ACTION-MS online program has been co-designed with people with MS, health professionals and carers to help ensure it is practical and relevant to the needs of those who may use the program. If you are interested in participating in the trial or would like further information, click here.
