INDIANAPOLIS—Cognitive behavioral therapy (CBT) can be an effective treatment for psychiatric and interpersonal problems in patients with multiple sclerosis (MS), according to research presented at the 2015 CMSC Annual Meeting. Data indicate that CBT can reduce anxiety and depression and improve marital satisfaction and marital communication.
CBT is a form of psychotherapy that identifies patterns of thought and behavior that change with depression or other mood disorders, said Frederick W. Foley, PhD, Professor of Psychology at Yeshiva University in Bronx, New York. The treatment helps people change these patterns of thinking and behavior to lessen the symptoms of the mood disorder or achieve remission.
Dr. Foley and colleagues examined 40 patients with MS in a study published in Journal of Consulting and Clinical Psychology. The investigators randomized the participants to current available care or stress inoculation training (SIT), which included CBT and progressive deep-muscle relaxation training adapted for patients with MS. At the end of the trial, Dr. Foley and colleagues found that participants randomized to SIT had significantly less depression, anxiety, and distress, compared with participants who received current available care. In addition, individuals randomized to SIT used more problem-focused coping strategies than those randomized to current available care.
In a pilot study published in Multiple Sclerosis in 2001, Dr. Foley and colleagues tested the efficacy of a counseling intervention that included CBT in nine couples with MS and sexual dysfunction. The intervention included 12 counseling sessions, communication with the MS medical treatment team, education, and tailoring of symptomatic treatments so that they would interfere less with sexual function. Repeated measures analysis of variance indicated that the couples had significant improvements in affective and problem-solving communication, marital satisfaction, and sexual satisfaction during the treatment, compared with a phase of the study during which they were on a waiting list. Patients with MS and their spouses reported similar levels of improvement.
CBT also may improve marital communication for patients with MS and cognitive disorders. In a study published in Journal of Neurologic Rehabilitation, Dr. Foley and colleagues developed templates to enable patients and their spouses to communicate. The investigators taught participants listening skills, how to empathize with their spouses using templates, and how to make positive (ie, noncritical) requests. In addition, the researchers instructed participants in how to provide feedback when their spouse’s behavior is not acceptable, as well as how to make positive requests for changes in behavior. This intervention has not been studied in a randomized controlled trial, however.
—Erik Greb