Group therapy helps multiple sclerosis patients cope with depression

Jun 13, 2011

Offering multiple sclerosis (MS) sufferers emotional support through group therapy sessions could improve their quality of life and save the NHS almost £500 per patient, a study at The University of Nottingham has discovered.

Researchers are now planning a larger multicenter study into the issue to establish whether psychological therapy should be incorporated into the multiple sclerosis services currently provided by the NHS.

The study, funded by the Multiple Sclerosis Society, was led by Professor Nadina Lincoln, of the University’s Institute of Work, Health, and Organisations. She said: “These are very encouraging findings as many people with MS have problems with depression and anxiety and there are few treatments provided in NHS clinical services to address these. It is important that the psychological effects of MS are fully recognized as they can have a devastating effect on people’s lives.”

Previous studies have suggested that depression in multiple sclerosis can lead to patients failing to take their medication and a reduced quality of life. National Institute for Health and Clinical Excellence (NICE) guidelines also recognize that many people with both multiple sclerosis and depression or anxiety would prefer not to take antidepressants and recommends that psychological therapies should be offered as an alternative.

For the Nottingham study researchers recruited multiple sclerosis patients currently attending clinics run by Nottingham University Hospitals NHS Trust, as well as inviting referrals from specialist multiple sclerosis nurses and placing adverts in publications produced by the Multiple Sclerosis Society.

The volunteers were asked to complete questionnaires about how multiple sclerosis affects their daily lives and the extent to which they felt in control.

The patients were then randomly divided into 2 groups of just over 70 people. One group received all the usual care offered to multiple sclerosis patients and were put on a waiting list to receive group therapy at the end of the study.

The other group was invited to attend a course of six 2-hour sessions of group therapy attended by up to 8 participants at a time. Each session was led by a research psychologist, supervised by a qualified clinical psychologist with experience of working with people with multiple sclerosis.

Each session focussed on a topic, such as worry, gloom, and relationships, and was followed by practical exercises in strategies to cope with emotional problems and group discussion. They finished with relaxation exercises and group members were given tasks centred on practicing coping strategies between sessions.

To assess the effectiveness of the sessions, questionnaires were sent to the participants at both 4 and 8 months later and the results of those who received treatment were compared to those on the waiting list only.

The researchers found that those multiple sclerosis sufferers who attended the group sessions had fewer problems with anxiety and depression, the impact of the disease on their daily lives was reduced, and their quality of life improved.

In terms of potential savings to the NHS, the researchers have also collected information on cost, which will be submitted for a future publication. They found that costs were reduced by £470 per patient for those who attended the therapy sessions compared with usual care. It was shown to almost halve the cost of visits to the GP, falling from £11,340 at the start of the study to just £5,832 at the 8 month follow up. The costs of outpatient hospital visits were also slashed from £32,592 at the beginning of the study to £21,534 at the 8-month follow-up.

The next stage of the research will be to assess whether the group therapy approach works equally well in other centers through a larger study with the hope that the treatment could potentially be provided through NHS services for those with multiple sclerosis.

Dr Susan Kohlhass from the Multiple Sclerosis Society said: “Knowing group-based sessions can reduce anxiety and depression is a strong development towards improving the quality of peoples’ lives with MS. We are committed to funding work that will imminently benefit people with the condition and this is a great example. The next stage will be to find if this approach is as effective in other areas of the country.”

The study, which is due to be published in the journal Multiple Sclerosis, was funded with a grant from the Multiple Sclerosis Society.

Source: News Release
University of Nottingham
June 13, 2011