The importance of nonpharmacological strategies and the management of depression in patients with multiple sclerosis: an integrative review

Abstract

Introduction: Multiple sclerosis (MS) is a chronic and demyelinating disease of the central nervous system. Among the symptoms that patients with MS may develop, depression stands out, which is associated with an important decline in quality of life. The presence of this symptom is associated with a worse prognosis. There is much support in the literature of the positive role that non-pharmacological measures play in controlling depression in patients with MS, with a range of options for the patient to choose from. Objectives: To analyze studies that deal with non-pharmacological therapeutic strategies against depression in patients with MS. Methods: This scientific article was written in the form of an integrative literature review, which used the databases of the Scielo and the PubMed as a source of extraction of publications. The keywords used were: “Multiple sclerosis”, “Depression” and “Complementary Therapies”’. Among the inclusion criteria, articles were included between the years 2015 and 2020, published in English or Portuguese, available in full and in the form of meta-analyzes, systematic reviews and randomized clinical trials. Results: The bibliographic survey carried out led to 15 scientific articles, all of which were randomized clinical trials and published in English. The articles reported that non-pharmacological interventions, such as Cognitive Behavioral Therapy, physical activity, yoga, Guided Imagery, mindfulness and diet, had positive effects on depressive symptoms in MS. Conclusion: The survey of data for the construction of the scientific article led to the conclusion that non-pharmacological measures play an important role in the control of depressive episodes in patients with MS. The combination of drug therapy and non-pharmacological practice leads to better responses.