Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

Mohr, David C.; Boudewyn, Arne C.; Goodkin, Donald E.; Bostrom, Alan; Epstein, Lucy A.

doi:10.1037/0022-006x.69.6.942

Cited by 302 publications

(226 citation statements)

References 64 publications

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“…[52] Moreover, attrition is typically very low for the CBT intervention in these trials (5%). Recent studies have also shown that CBT delivered by telephone is an effective form of psychotherapy for depression in MS relative to usual care [53] and relative to a telephone delivered supportive emotion-focused therapy.…”

Section: C2 Psychotherapymentioning

confidence: 99%

“…Attrition was greatest for the sertraline group, with 29% dropping out prior to completing the study. [52] Several conclusions can be drawn from the available literature on pharmacotherapy for depression in MS. First, antidepressants reduce depressive symptom severity in persons with MS and should be considered for treating MDD in this patient population. However, although depressive symptoms may be responsive to pharmacotherapy, they do not necessarily result in full remission of symptoms for all individuals with MS who use them.…”

Section: Treatment Of Depression In Msmentioning

confidence: 99%

“…Several randomized controlled trials have demonstrated the effectiveness of CBT for treatment of major depressive disorder among persons with MS. [52][53] In these studies, response rates to CBT have been equal to or higher than response rates to antidepressant medications or to other psychotherapy modalities, with response rates approaching 50% of patients. [52] Moreover, attrition is typically very low for the CBT intervention in these trials (5%).…”

Section: C2 Psychotherapymentioning

confidence: 99%

“…The Goldman Consensus group has recommended that psychotherapy, particularly cognitive behavior therapy (CBT), be offered as a treatment option for persons with MS and depression. [12] As skills learned through CBT produce improvements beyond the nonspecific effects of supportive treatment [52], standard CBT for depression may be considered as the treatment of choice.…”

Section: C2 Psychotherapymentioning

confidence: 99%

See 3 more Smart Citations

Psychiatric Issues in Multiple Sclerosis

Chwastiak

Ehde

2007

Psychiatric Clinics of North America

133

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Section: C2 Psychotherapymentioning

confidence: 99%

Section: Treatment Of Depression In Msmentioning

confidence: 99%

Section: C2 Psychotherapymentioning

confidence: 99%

Section: C2 Psychotherapymentioning

confidence: 99%

See 2 more Smart Citations

Psychiatric Issues in Multiple Sclerosis

Chwastiak

Ehde

2007

Psychiatric Clinics of North America

133

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“…Electro convulsive therapy (ECT) has been shown to be effective in severe depression but can result in exacerbation of symptoms of MS. 21 Results from trials of individual or group psychological treatments have shown more promise and cognitive behavioural therapy (CBT) can be helpful in mild to moderate depression and as effective as treatment with the SSRI sertraline. 22 A well-conducted RCT of telephone-administered CBT compared with a control group of supportive therapy by telephone demonstrated a significant reduction in cases of depression and depressive symptoms after CBT but the difference between the groups was no longer significant at one year follow-up. 23 Treatment of depression in MS remains difficult and is poorly guided by evidence but the Golman Consensus Group recommends individualised treatment of moderate to severe depression with a combination of an antidepressant and a form of psychotherapy: either supportive therapy, CBT or interpersonal therapy.…”

mentioning

confidence: 99%

Management of neuropsychiatric symptoms in multiple sclerosis

Sommerlad¹,

Price²,

Trip³

2014

Prog Neurol Psychiatry

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M ultiple sclerosis (MS) is the commonest cause of neurological disability in young and middleaged adults. 1 The characteristic pathological features are demyelinating plaques, astrocytic gliosis and immune-mediated inflammation anywhere within the CNS, with the periventricular region, brainstem, juxta cortical region, optic nerves and spinal cord being particularly common targets. The neurological manifestations are diverse, although they usually reflect the function of the affected anatomical site, and the course of the illness is variable and initially difficult to predict with accuracy.In 80-90 per cent of cases, MS is relapsing-remitting in nature with two-thirds of these cases developing a secondary progressive form of the condition a variable number of years after onset and a third having a relapsing-remitting course that does not result in long-term serious disability. The remaining 10-20 per cent of patients have a primary progressive course with gradually worsening symptoms. 2 The prognosis can be poor in the long term but progression is frequently slow; recent evidence suggests a median of 28 years before a stick is required for walking. 3 The UK annual incidence of MS is 10 in 100 000 with a prevalence of 200 in 100 000. 4 There is estimated to be over 100 000 people suffering from the condition in the UK. The median age of onset is 31 years and it is approximately twice as common in women. 5 It has a multifactorial aetiology with genetic and environmental factors shown to be important. There is 31 per cent monozygotic concordance compared to 5 per cent in dizygotic twins 6 while the environmental influence is demonstrated by marked variations in prevalence in genetically homogenous populations. 7 Prevalence increases with increasing distance from the equator and those who emigrate in childhood have prevalence rates consistent with their adopted country. 8 MS commonly presents with weakness, tingling or numbness in the limbs; diplopia, visual loss or impaired visual acuity; vertigo; dysarthria and ataxia; fatigue; and bladder and bowel disturbance. 5 The array of presenting symptoms in MS can lead to diagnostic uncertainty and neuropsychiatric conditions such as somatisation disorder are sometimes suspected. A study demonstrated that 16 per cent of patients with MS had been referred to a psychiatrist between the onset of neurological symptoms and diagnosis of MS. In spite of neurological symptoms being present in the majority of cases, these remained largely overlooked and diagnoses of conversion disorder and hysterical personality disorder were applied, 9 although the increased use of MRI scans since this finding was reported has improved diagnostic accuracy. While neurological features are the most recognised manifestations of MS, psychopathology, including affective, psychotic and cognitive disorders, is also common. The identification of these symptoms is often more difficult and diagnosis can be delayed. Psychiatric symptoms can occur at onset or later in the MS disease process and initial psych...

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