CBT effective for MS depression, but requires upkeep: Study

Cognitive behavioral therapy (CBT), delivered in person, online, or by telephone, can ease depression in adults with multiple sclerosis (MS) within about two months, but diminishing benefits over time show that follow-up sessions may be needed, according to a meta-analysis of multiple studies.

“This recommendation aims to serve as a reference for clinical practice, optimizing the efficacy of CBT in the treatment of depression,” researchers wrote in the study, “Effectiveness of cognitive behavioral therapy for depression in patients with multiple sclerosis: A systematic review and meta-analysis,” published in Medicine.

MS symptoms in adults include cognitive issues, such as poor memory and concentration, as well as mental health problems such as anxiety and depression. These challenges can affect patients’ well-being and make it difficult to adjust to life with MS.

While an estimated one in four patients will experience severe symptoms of depression in the year after being diagnosed with MS, treatment strategies “generally fall short,” the researchers wrote. However, there is growing evidence that CBT, a type of talk therapy that focuses on identifying and modifying negative thoughts and behaviors, may help.

CBT can be delivered in the clinic or at home, and it is flexible enough to be tailored to each patient’s needs. “The advantage of individual CBT lies in its personalized approach, allowing therapists to create tailored treatment plans based on the specific issues of each patient, thus providing a higher sense of privacy and security,” the researchers wrote.

Recommended Reading

Jan. 23, 2025 Columns by Benjamin Hofmeister

With MS, my mental health had to get worse before it got better

Depression eases after 2-3 months, studies show

The team reviewed and combined data from 22 studies involving 1,558 patients. Twenty were randomized controlled studies, meaning patients were randomly assigned to CBT or a control intervention.

Studies were from the U.S., the U.K., Iran, Italy, and Germany. Some patients had face-to-face sessions of CBT, while others used online platforms or telephone calls. Sessions could be one on one or in a group, and they usually lasted 30 to 120 minutes over six to 16 weeks (about four months).

CBT, independent of its delivery method and in either individual or group settings, helped ease depression in adults with MS after two to three months, though no clear benefits were seen in the first month. Improvements became evident from the second month onward and lasted up to six months, but were no longer clearly sustained at one year.

Since benefits may decrease over time, repeating CBT within six months may help maintain improvements, the researchers said. They suggested therapists consider continuing treatment for about two months, and encourage follow-up sessions within six months after CBT ends to help maintain more stable and lasting benefits.

“Patients with MS can flexibly choose the delivery modality of CBT based on their individual circumstances,” while “integrating regular follow-ups and feedback mechanisms will help monitor progress and make necessary adjustments,” the researchers wrote.