Depression occurs in people with MS approximately 2-3 times more often than in the general population, and is less likely to subside without effective treatment. Depression in people with MS has been linked to poorer outcomes, including lower quality of life and employment, greater difficulties with thinking and feelings of helplessness, poorer relationships with family and friends and greater difficulty with self-care. Despite this, international research shows that detection of depressive symptoms is sub-optimal, missing up to 36% of people with MS and depression. Once depressive symptoms are detected, only about 46% of people are referred for treatment. Furthermore, up to 65% of people receiving treatment still report moderate-to-severe depression, suggesting treatment requires greater monitoring and adjustment.
Although clearly there is a need for better detection, referral and treatment of depressive symptoms, it is unclear what the best strategy is to improve current practice. This study aims to investigate 1) how depression is assessed and managed by healthcare professionals in MS specialist clinics, and 2) what barriers exist to assessing and treating depression for healthcare professionals and people with MS. Dr Lisa Grech and her team will interview neurologists, nurses and people with MS to answer research questions. This will lead to a better understanding of the issues and will inform further proposals to assess these issues in a larger national sample of MS healthcare professionals and people with MS. The results of this will inform recommendations to improve the identification and treatment of depression in people with MS.
Dr Grech has carried out interviews with 15 MS specialist clinicians (including both neurologists and MS nurses) and 26 people with MS. These interviews were designed to determine current practices and barriers in the assessment, treatment and follow-up of depression in MS clinics.
The interview data has been analysed and the findings written up into two scientific manuscripts which are being submitted for publication. Some of the findings include, identifying difficulties with collaborative treatment and monitoring support from GPs, and that people with MS themselves don’t often identify emotional difficulties as needing treatment or recognise that they can be treated. This can be a barrier in itself to providing support. Barriers and challenges were identified from both the perspective of healthcare professionals as well as from people with MS.
Future work includes confirming these findings with a broader survey and assembling an expert advisory committee to guide the development and implementation of recommendations from both the literature and this research to improve the outcomes for people with MS experiencing depression.
We look forward to reporting further updates as this work hopefully makes its way into the scientific literature and clinical practice.
Updated: 1 April 2021
Updated: 21 January, 2020
Laboratory research that investigates scientific theories behind the possible causes, disease progression, ways to diagnose and better treat MS.
Research that builds on fundamental scientific research to develop new therapies, medical procedures or diagnostics and advances it closer to the clinic.
Clinical research is the culmination of fundamental and translational research turning those research discoveries into treatments and interventions for people with MS.