An online programme to reduce depression in patients with multiple sclerosis: a randomised controlled trial. (March 2015)

• Record Type: Journal Article
• Authors: Fischer, Anja; Schröder, Johanna; Vettorazzi, Eik; Wolf, Oliver T; Pöttgen, Jana; Lau, Stephanie; Heesen, Christoph; Moritz, Steffen; Gold, Stefan M
• Is Part Of: Lancet. Volume 2:Number 3(2015)
• Page Start: 217
• Page End: 223
• Publication Date: 2015-03
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1016/S2215-0366(14)00049-2
• Languages: English
• ISSNs: 2215-0366

Abstract

<abstract abstract-type="author" id="ceab10"> <title id="cestitle10">Summary</title> <sec> <title id="cestitle20">Background</title> <p id="spara110">With a lifetime risk for major depressive disorder of up to 50%, depression is a common comorbidity in multiple sclerosis but remains widely underdiagnosed and untreated. We investigated the potential of a fully automated, internet-based, cognitive behavioural therapy programme, Deprexis, to reduce depressive symptoms in patients with multiple sclerosis.</p> </sec> <sec> <title id="cestitle30">Methods</title> <p id="spara120">For this randomised controlled trial, we recruited patients from an outpatient clinic in Hamburg, Germany. Patients aged 18–65 years were eligible for inclusion if they had multiple sclerosis and self-reported depressive symptoms. By use of a computer-generated randomisation sequence, we allocated 90 patients (1:1; no blocking or stratification) to either the intervention group or a waitlist control group for 9 weeks. The primary endpoint was the Beck Depression Inventory (BDI), as assessed by an intention-to-treat analysis. This trial is registered with <ext-link ext-link-type="unknown" id="interrefs10" xlink:type="simple" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>, number <ext-link ext-link-type="unknown" id="interrefs20" xlink:type="simple" xlink:href="ctgov:NCT01663649" xmlns:xlink="http://www.w3.org/1999/xlink">NCT01663649</ext-link>.</p> </sec> <sec> <title id="cestitle40">Findings</title> <p id="spara130">71 patients completed the trial: 35 patients in the intervention group and 36 patients in the control group. During the intervention, BDI scores decreased in the Deprexis group and increased in the control group, yielding a positive effect of Deprexis relative to the waitlist group (mean group difference −4·02 points [95% CI −7·26 to −0·79], p=0·015, effect size d=0·53). Worsening of depressive symptoms from below to above the clinical cutoff (BDI >13) occurred in three (7%) of 45 patients in the control group and no patients in the Deprexis group. We noted no adverse events with respect to new occurrence of suicidal ideation during the trial.</p> </sec> <sec> <title id="cestitle50">Interpretation</title> <p id="spara140">Psychological online-intervention programmes could be suitable for patients with multiple sclerosis who are unable to regularly attend therapeutic sessions because of mobility impairments.</p> </sec> <sec> <title id="cestitle60">Funding</title> <p id="spara150">European Union and the Deutsche Forschungsgemeinschaft.</p> </sec> </abstract>