Effectiveness of cognitive behavioral therapy for depression in patients with multiple sclerosis: A systematic review and meta-analysis
Clinical Snapshot
PICO Framework
| P — Population | Patients with multiple sclerosis experiencing depression |
| I — Intervention | Cognitive behavioral therapy (individual or group, delivered face-to-face, online, or via telephone) |
| C — Comparator | Control groups (not specified in abstract - likely usual care, waitlist, or placebo) |
| O — Outcomes | Depression severity/symptoms, measured at various time points including 2 months during intervention and up to 6 months post-intervention |
Bottom Line
This systematic review suggests CBT is effective for depression in multiple sclerosis patients across various delivery modalities. However, the abstract provides insufficient quantitative data to assess clinical significance or certainty of evidence. While the inclusion of 22 studies and use of Cochrane risk of bias tools suggests methodological rigor, critical details about effect sizes, heterogeneity, and study quality are missing. The finding that benefits emerge at 2 months and persist to 6 months is clinically relevant, suggesting both immediate and sustained effects. For Australian clinicians, the multiple delivery options (including telehealth) align well with Medicare Better Access provisions and could address geographic barriers in MS care. However, full paper review is essential before implementing practice changes, as the abstract lacks sufficient detail for evidence-based decision making.
Key Findings
P Value: Not reported
Effect Size: Not reported in abstract - described as 'significant improvements'
Primary Outcome: Depression severity/symptoms in patients with multiple sclerosis
Nnt Or Sensitivity: Not calculable from available data - clinical significance unclear
Confidence Interval: Not reported
Clinical Application
High feasibility suggested given multiple delivery options (face-to-face, online, telephone) and both individual and group formats available Relevant to Australian MS services through MS Australia and state-based MS societies. CBT is PBS-subsidised through Medicare Better Access scheme. Telehealth delivery particularly relevant for rural/remote Australian MS patients given geographic challenges. Patients with multiple sclerosis experiencing depression, likely applicable across different healthcare settings given multiple delivery modalities examined
Abstract
BACKGROUND: The efficacy and methodologies of cognitive behavioral therapy (CBT) for treating depression in multiple sclerosis (MS) require further comprehensive research. METHODS: Two researchers conducted independent literature searches across 5 databases, utilizing the keywords "multiple sclerosis," "cognitive behavioral therapy," and "depression," without any restrictions on publication year. The Cochrane Risk of Bias Tool 2.0 was utilized to assess the included studies. Statistical analyses were conducted using standardized mean difference as the effect size with Stata 17.0 software. RESULTS: This meta-analysis included 22 studies. The results indicate that, regardless of whether delivered face-to-face, online, or via telephone, both individual and group CBT effectively alleviate depression in patients with MS. Significant improvements in depressive symptoms were observed starting from the second month of intervention and persisted for up to 6 months post-intervention. CONCLUSION: Patients with MS can flexibly choose the delivery modality of CBT based on their individual circumstances while engaging in treatment for around 2 months. They are encouraged to reengage in CBT within 6 months post-intervention to ensure the continuity and stability of depression treatment outcomes. Healthcare providers can offer various CBT delivery modalities based on the individual preferences and circumstances of patients with MS, while developing corresponding plans to enhance the effectiveness of depression management.
References
- 1.Xu, W., Shen, B., Xu, H., Zhou, Y., & Wang, Y. (2026). Effectiveness of cognitive behavioral therapy for depression in patients with multiple sclerosis: A systematic review and meta-analysis. Medicine, Article 0000000000048327. https://doi.org/10.1097/MD.0000000000048327
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