- Study results showed significant improvements in symptoms of depression, anxiety and disability in the treatment group.
- The intervention was found to be highly acceptable, with no adverse treatment events reported.
- Further research is underway to broaden the scope of this study.
What was the aim of the research?
Depression and anxiety are common among individuals living with neurological disorders, including MS, and are often linked with poor mental health and functional difficulties.
Unfortunately, accessible, supportive care options are limited for these patients.
To address this issue, a study led by Dr Milena Gandy and her team at Macquarie University investigated whether internet-based psychological interventions could serve as a suitable form of accessible, supportive care for individuals with neurological disorders like MS.
What did the researchers do?
In this study published in the journal of Psychological Medicine, 215 participants with a confirmed diagnosis of epilepsy, multiple sclerosis, Parkinson’s disease or an acquired brain injury participated in the trial.
Participants were allocated to either an immediate treatment group (111 participants) or treatment as usual waitlist control group (104 participants).
The immediate treatment group received an online “Wellbeing Neuro Course” developed by the researchers. The course consisted of six lessons, delivered over 10 weeks with support from a psychologist via email and telephone.
The online course was based on cognitive behaviour therapy (CBT) principles and aimed to teach skills for managing mental health issues such as depression and anxiety, as well as functional difficulties associated with neurological disorders.
The waitlist control group commenced treatment after the treatment group had completed the 10-week online intervention. The study’s primary objective was to determine whether participants in the treatment group reported significant improvements in symptoms of depression, anxiety and disability immediately after the intervention compared to the control group.
The study also assessed whether improvements were maintained at the three-month follow-up.
What did the study find?
The study revealed significant differences between the treatment and control groups, with immediate treatment group participants reporting greater improvements in symptoms of depression, anxiety and disability (24% for depression and anxiety combined, 15% for disability) compared to controls which showed no improvement (-3%, all outcomes).
The analysis revealed the largest treatment effects were observed in participants with clinical levels of depression, anxiety and disability at baseline.
The treatment group also reported significant improvements in measures of cognitive function, emotional and behavioural dyscontrol (impairment in the ability to self-regulate behaviour resulting in impulsive or inappropriate actions), and the use of cognitive strategies, compared to the control group.
Treatment-related improvements were maintained at the three-month follow-up, and no adverse events were reported throughout the study. Findings were achieved with minimal clinician time required, highlighting the public health potential of this approach to care.
Overall, these findings highlight the potential of internet-based psychological interventions, such as the Wellbeing Neuro Course, to improve mental health and functional outcomes. This approach may provide a much-needed form of accessible, supportive care for patients with limited treatment options.
What does this mean for people with MS?
Depression and anxiety are commonly experienced by people living with MS, affecting up to 40% of individuals, nearly double the rate found in the general population.
Depression and anxiety can arise from various factors, including the psychological impact of a diagnosis of a chronic illness like MS.
Mental health conditions may also be associated with increased inflammation, fatigue and disability, and when left untreated, depression and anxiety can significantly reduce quality of life.
Historically, people living with MS have been expected to seek out separate clinical care when experiencing poor mental health and wellbeing.
However, accessing psychological support can be challenging for many people living with MS due to mobility issues, high costs, fatigue, and a lack of trained specialists with knowledge of MS.
Moreover, individuals residing in rural and remote areas may have limited access to traditional face-to-face psychological treatment.
This study provides a promising solution to address the barriers many people living with MS face in accessing psychological support. By delivering the specifically designed course online, individuals can receive care regardless of their location or physical limitations.
The results of this study are particularly encouraging, as participants allocated to the immediate treatment group reported significant and clinically meaningful improvements in measures of mental health, such as depression and anxiety, as well as functional outcomes, including disability and perceived cognitive difficulties.
MS Australia is now supporting an extension of this study through a postdoctoral fellowship grant awarded to Dr Milena Gandy in 2022.
Dr Gandy and her team will take this research to the next stage and investigate the effectiveness, acceptability, and safety of this treatment approach in real-world settings, including delivery via a hospital-based MS clinic.
If the results of the new study are positive, digital psychological treatments such as the one used in the current study may become a feasible and sustainable new model of care.
