Group therapy helps MS sufferers cope with depression, study finds

June 13, 2011

Offering Multiple Sclerosis 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 multi-centre study into the issue to establish whether psychological therapy should be incorporated into the MS services currently provided by the NHS.

The study, funded by the MS 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 recognised as they can have a devastating effect on people's lives."

Depression and anxiety are common among sufferers of MS, a disabling neurological condition that affects around 100,000 people in the UK.

Previous studies have suggested that depression in MS 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 recognise that many people with both MS 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 MS patients currently attending clinics run by Nottingham University Hospitals NHS Trust, as well as inviting referrals from specialist MS nurses and placing adverts in publications produced by the MS Society.

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

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

The other group were invited to attend a course of six two-hour sessions of group therapy attended by up to eight 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 MS.

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 practising coping strategies between sessions.

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

The researchers found that those MS 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 eight 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 eight-month follow-up.

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

Dr Susan Kohlhass from the MS 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."

Future research will greatly benefit from the MS Society-supported MS Register project. The MS Register is the world's first (in any condition) that brings together information submitted by people, alongside data provided by clinicians and other routinely collected information. MS patients can register through their own portal via www.ukmsregister.org which is now open to anyone with MS. The register will facilitate access to research studies, while the information from clinicians will come through a different portal. Nottingham is one of five centres where this project, coordinated by a team from the University of Swansea, is being piloted initially.

The study, which is due to be published in the journal Multiple Sclerosis, involved a multidisciplinary team of researchers from the University's Institute of Work, Health and Organisations, Division of Rehabilitation and Ageing, Division of Clinical Neurology and Trent Research and Development Support Unit in collaboration with the University of Swansea. The study was funded with a grant from the Multiple Sclerosis Society.
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The paper is now available via the journal's OnlineFirst section on the web at http://msj.sagepub.com/content/early/2011/05/19/1352458511408753.abstract

University of Nottingham

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