Unit Management of Depression of Patients with Multiple Sclerosis Using Cognitive Remediation Strategies: A Preliminary Study

Abstract

Multiple sclerosis (MS) is a chronic, often progressive neurologic disorder characterized by cerebral and spinal cord lesions. Patients with advanced MS often require continuous supervision in a long-term skilled nursing facility. Many of these patients experience clinical levels of depression. For this experiment, we randomly assigned MS patients living in a skilled nursing facility to either a control condition or an extended treatment protocol. The protocol consisted of assigning individual certified nursing assistants (CNAs) to each patient, in-service training for the CNAs, and the use of memory notebooks. All patients completed the short version of the Beck Depression Inventory and several measures of cognitive functioning at the start and end of the study. The results indicate statistically and clinically significant improvements in the depression of patients in the treatment but not in the control condition. These results led to recommendations for the treatment of MS patients living in long-term skilled nursing facilities and for additional research.

Cognitive rehabilitation in multiple sclerosis: a randomized controlled trial

“…Our finding that cognitive rehabilitation improved self‐reported psychological well‐being at four, but not at seven, months is partly consistent with the significant reduction in symptoms of depression reported in previous cognitive rehabilitation studies of patients with MS . It also concurs with the findings from an RCT investigating the effects of memory rehabilitation in MS, where no effect of the intervention on mood was reported , and with the review recently conducted by Rosti‐Otajarvi and Hamalainen , where no evidence of the effect of neuropsychological rehabilitation on emotional functions were found.…”

Cognitive rehabilitation in multiple sclerosis: a randomized controlled trial

“…Our finding that cognitive rehabilitation improved self‐reported psychological well‐being at four, but not at seven, months is partly consistent with the significant reduction in symptoms of depression reported in previous cognitive rehabilitation studies of patients with MS . It also concurs with the findings from an RCT investigating the effects of memory rehabilitation in MS, where no effect of the intervention on mood was reported , and with the review recently conducted by Rosti‐Otajarvi and Hamalainen , where no evidence of the effect of neuropsychological rehabilitation on emotional functions were found.…”

Short-Term Cognitive Training Improves Mental Efficiency and Mood in Patients with Multiple Sclerosis

“…partial deterioration. This in particular reflects the general problem of follow-up training tests in a chronic progressive disease like MS hampering clearly comparable follow-up examinations, even if patients do not suffer a clinically obvious relapse or physical deterioration [30,31,32]. Interestingly, yet beyond the scope of this study, we were able to re-test 7 patients for a third time.…”

Efficacy of a short cognitive training program in patients with multiple sclerosis

“……”

Cognitive rehabilitation in multiple sclerosis: a randomized controlled trial

“…Our finding that cognitive rehabilitation improved self‐reported psychological well‐being at four, but not at seven, months is partly consistent with the significant reduction in symptoms of depression reported in previous cognitive rehabilitation studies of patients with MS . It also concurs with the findings from an RCT investigating the effects of memory rehabilitation in MS, where no effect of the intervention on mood was reported , and with the review recently conducted by Rosti‐Otajarvi and Hamalainen , where no evidence of the effect of neuropsychological rehabilitation on emotional functions were found.…”

Short-Term Cognitive Training Improves Mental Efficiency and Mood in Patients with Multiple Sclerosis

“…partial deterioration. This in particular reflects the general problem of follow-up training tests in a chronic progressive disease like MS hampering clearly comparable follow-up examinations, even if patients do not suffer a clinically obvious relapse or physical deterioration [30,31,32]. Interestingly, yet beyond the scope of this study, we were able to re-test 7 patients for a third time.…”

Efficacy of a short cognitive training program in patients with multiple sclerosis

“……”

Cognitive rehabilitation in multiple sclerosis: a randomized controlled trial

“…Our finding that cognitive rehabilitation improved self‐reported psychological well‐being at four, but not at seven, months is partly consistent with the significant reduction in symptoms of depression reported in previous cognitive rehabilitation studies of patients with MS . It also concurs with the findings from an RCT investigating the effects of memory rehabilitation in MS, where no effect of the intervention on mood was reported , and with the review recently conducted by Rosti‐Otajarvi and Hamalainen , where no evidence of the effect of neuropsychological rehabilitation on emotional functions were found.…”

Short-Term Cognitive Training Improves Mental Efficiency and Mood in Patients with Multiple Sclerosis

“…partial deterioration. This in particular reflects the general problem of follow-up training tests in a chronic progressive disease like MS hampering clearly comparable follow-up examinations, even if patients do not suffer a clinically obvious relapse or physical deterioration [30,31,32]. Interestingly, yet beyond the scope of this study, we were able to re-test 7 patients for a third time.…”

Efficacy of a short cognitive training program in patients with multiple sclerosis

“……”