Psychological Interventions Improve Quality of Life for People With MS

Psychological therapies are effective for people with multiple sclerosis (MS), showing benefits across mental health, cognitive function, physical well-being, and quality of life. These findings were recently published in Journal of Neurology.

People with MS often experience emotional distress that worsens other MS symptoms. While psychological therapies may help, past research has focused on individual treatments rather than the broader category. To address this, researchers conducted a systematic review, individual meta-analyses, and a network meta-analysis to evaluate the overall effectiveness of psychological interventions in MS.

Included studies were randomized controlled trials assessing live, professionally delivered psychological interventions for people with MS. Common interventions included cognitive behavioral therapy, mindfulness-based interventions, acceptance and commitment therapy, dialectical behavioral therapy, and positive psychotherapy. Most involved 8 sessions lasting 45 to 150 minutes each.

In total, 111 studies were included in the systematic review, 89 in the meta-analysis, and 77 in the network meta-analysis. Participants ranged in age from 18 to 78 years, 71.7% had relapse-remitting MS, and the majority were women.

In the network meta-analysis, all interventions showed a trend toward improvement, though none reached statistical significance. The greatest effect compared with control was seen with cognitive behavioral therapy (mean difference, 11.0; 95% CI, 5.72-16.2)

In individual meta-analyses, studies were grouped by primary outcomes: 20 assessed quality of life, 17 cognition, 14 physical health, and 48 mental health. Psychological interventions significantly improved tested outcomes:

• Quality of life (standardized mean difference, 0.77; 95% CI, 0.21-1.34; P =.007)
• Cognition (standardized mean difference, 0.66; 95% CI, 0.24-1.07; P =.002)
• Physical health (standardized mean difference, 1.08; 95% CI, 0.41-1.74; P <.00001)
• Mental health (standardized mean difference, 1.41; 95% CI, 1.00-1.83; P <.00001)

Additional meta-analyses showed significant improvements in anxiety, depression, and sleep (all P <.00001). However, the effects of psychological interventions on pain did not reach significance.

Study limitations included studies with inconsistent reporting and the use of studies with an unclear or high risk of bias.

“Our findings demonstrate that psychological therapies should be considered in the routine care of PwMS [people with MS] for a wide range of outcomes,” the study authors concluded.