Article

The aims were to evaluate (a) the feasibility of face-to-face cognitive
behavioural therapy (CBT) in people with MS (PwMS) with depressive symptoms; (b)
the feasibility of methods and measurements used; and (c) the outcome of the
intervention before the conducting of an equivalence study of comparative methods
of face-to-face CBT. DESIGN:
A single-group pilot feasibility study. PATIENTS:
PwMS (n = 15) with sub-threshold to moderate depressive symptoms, recruited at
the Karolinska University Hospital, Stockholm, Sweden. METHODS: The intervention
consisted of 15-20 sessions of face-to-face CBT. Feasibility outcomes included
recruitment rate, recruitment procedure and adverse events. Primary clinical
outcome was the Beck Depression Inventory-II (BDI-II). Follow-ups were conducted
after 3 weeks and 3 months. An estimated sample size calculation was conducted.
RESULTS: The face-to-face CBT intervention, methods and measurements used were
feasible. The outcome on BDI-II indicated that face-to-face CBT is an effective
method for alleviating sub-threshold to moderate depressive symptoms in PwMS.
CONCLUSION: Face-to-face CBT is feasible for use in PwMS aiming at decrease
depressive symptoms. For an equivalence study, a screening process for depressive
symptoms and two comparative intervention arms including traditional face-to-face
CBT and low-intensity face-to-face CBT is recommended. Primary outcomes should
include the BDI-II and also assessment of anxiety symptoms. Implications for
Rehabilitation Depression is common among people with MS (PwMS), however,
depressed PwMS do not always receive adequate treatment for depression which may
lead to increased disability and worse health-related quality of life (HRQL).
Cognitive behavioural therapy (CBT) is a psychological treatment method that
might be beneficial for PwMS with depressive symptoms, but the evidence is still
weak and further research is needed. The results from our pilot feasibility study
demonstrate that for an effectiveness study of face-to-face CBT for PwMS with
sub-threshold to moderate depressive symptoms the following points should be
acknowledged. The design of an effectiveness study should be a randomized
controlled trial including two treatment arms: traditional face-to-face CBT and a
low-intensity face-to-face CBT. To increase the inclusion rate a screening
process for depressive symptoms is recommended. Primary outcomes besides the Beck
Depression Inventory-II should include the Hospital Anxiety and Depression Scale
in order to capture anxiety symptoms and the Multiple Sclerosis Impact Scale-29
to capture HRQL.

Langue : ANGLAIS