- About a third of people with MS experience depression or anxiety.
- MS Australia-supported researchers assessed the effectiveness of the Wellbeing Neuro Course, an online treatment program for mental health in people with MS.
- The online treatment program resulted in meaningful long-term improvements in depression, anxiety and disability and is an accessible treatment option for mental health conditions.
Mental health in MS – what do we know so far?
About one-third of people with MS live with depression or anxiety. Mental health conditions add to the burden of living with MS and can significantly impact day to day functioning.
Mental health care is not usually built into routine MS care, meaning people with MS often have to arrange their mental health care separately. This may be hindered by costs, waiting times and difficulties with physically accessing services.
Cognitive behavioural therapy (CBT) is an evidence-based psychological treatment recommended for managing mental health in people with MS. Delivering treatments such as CBT online is a way to overcome some of the barriers to accessing mental health care for people with MS.
What did the researchers do?
MS Australia-supported researcher Dr Milena Gandy and her team assessed the effect of the Wellbeing Neuro Course on depression, anxiety and disability in people with MS.
The Wellbeing Neuro Course is an online 10-week treatment program that combines CBT with weekly or fortnightly contact with a clinical psychologist, by telephone or secure messaging system.
The CBT component of the course teaches skills to manage the impact of neurological disorders, including MS, on mental health and functional issues. It has six core modules and includes detailed case stories of people with neurological disorders to guide users in developing their skills. Each course module takes only 10-15 minutes to read and are designed to be kept simple to ensure users would not feel overwhelmed.
To assess the effectiveness of the treatment, study participants completed the following questionnaires before the treatment program (baseline), just after the treatment program and then at three and 12 months after finishing the program:
- Patient Health Questionnaire 9-item (PHQ-9): a nine-item questionnaire that measures depressive symptoms and their severity.
- Generalised Anxiety Disorder Scale 7-item (GAD-7): a seven-item questionnaire that measures anxiety symptoms and their severity.
- World Health Organisation Disability Assessment Schedule 2 (WHODAS 2.0): a 12-item questionnaire that assesses health and disability. It covers understanding and communicating, mobility, self-care, interacting with other people, life activities (domestic responsibilities, leisure, work and schools) and participating in community activities.
What did the researchers find?
Published in the Journal of Affective Disorders, 72 people with MS undertook the Wellbeing Neuro Course and were compared to 61 people who were still on the waiting list.
After the treatment, more people in the Wellbeing Neuro Course group showed meaningful improvements in depression, anxiety and disability than those on the waiting list group. More than half of those who did the course had meaningful improvements in depression (56%) and anxiety (60%). For people on the waiting list, this was only 18% and 13%, respectively. There were meaningful improvements in disability for a fifth of the people who took the course, compared to 5% of people who were on the waiting list. The improvements in the Wellbeing Neuro Course group were long-term and maintained at both three and 12 months after the course.
Nearly all participants (98%) said they were either very satisfied or satisfied with the Wellbeing Neuro Course. The course had no negative side effects.
What does this mean for people with MS?
This study shows that this online treatment is helpful for people with MS with self-reported mental health concerns and that improvements to mental health were long-term. The treatment had high user satisfaction rates and no negative side effects. As an internet-delivered treatment, it can be scaled up for larger populations and is accessible.
Further research with larger groups of participants is needed to confirm these findings and to be able to assess effectiveness for specific types of MS or by level of depression or anxiety symptoms.
This research used clinical psychologists. Future research conducted by non-specialists is needed to see whether the treatment program can be generalised to other healthcare settings. Being able to run an effective online mental health treatment program from a general healthcare setting would increase treatment access for people with MS dealing with depression and anxiety.
For more information on managing mental health in MS, click here.
