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Table 1 Study characteristics

From: Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: a systematic review and meta-analysis

Study Population Intervention Comparator(s) Outcomes (Primary, Secondary)
Larcombe (1984) [48] BDI ≥ 20; Self-reported depression ≥ 3 months; Met Feighner criteria for ‘definite’ or ‘probable’ depression; No psychological co-morbidities; Low suicide risk; Normal memory function; No concurrent or prior treatment with major tranquilisers or lithium. Diagnosis of MS confirmed by a neurologist Six weekly 90 minute group cognitive behavioural therapy sessions Waiting list for delayed treatment BDI; HRSD; Mood Ratings (3 item questionnaire, 10 point scale); Depression as rated by significant other (6 item questionnaire, 4 point scale)
Mohr (2001) [25] BDI ≥ 16; HRSD ≥ 16; Clinical diagnosis of MDD assessed using SCID; No psychological or neurological co-morbidities, suicidal tendencies or CNS disorders; Willingness to abstain from any other treatment for depression than that provided in the study. Confirmed diagnosis of MS (Poser criteria) Sixteen weekly 50 minute individually administered cognitive behavioural therapy sessions Supportive-expressive group therapy; Sertraline BDI; BDI-18; HRSD; MDD assessed using SCID
Mohr (2005) [47] BDI-II ≥ 16; HRSD ≥ 14; GNDS ≥ 3 on one or more areas of functioning; No co-morbid dementia, psychosis, substance abuse or suicidal tendencies; Not currently undergoing psychotherapy; No medication other than antidepressants. Diagnosis of MS confirmed by a neurologist Sixteen weekly 50 minute telephone administered cognitive behavioural therapy sessions Telephone administered supportive emotion-focused therapy BDI-II; HRSD; MDD assessed using SCID; Positive affect measured using PANAS-PA
Mohr (2000) [45] POMS-DS ≥ 15; If in treatment for depression must have been in that treatment for ≥ 3 months; No co-morbid dementia or neurological disorders. Confirmed diagnosis of MS (Poser criteria) Eight weekly 50 minute telephone administered cognitive behavioural therapy sessions Standard care POMS-DS; Post-treatment adherence to IFNβ-1a
Forman (2010) [43] Diagnosis of MS > 3 months; HADS ≥ 8 or GHQ-12 ≥ 3 Six fortnightly 120 minute group therapy sessions based on cognitive-behavioural and psycho-educational framework Standard care HADS; GHQ-12; MSIS; MSSE; SF-36
Lincoln (2011) [44] Diagnosis of MS > 12 months; HADS ≥ 8 or GHQ-12 ≥ 3. Diagnosis of MS confirmed by a neurologist Six fortnightly 120 minute group therapy sessions based on cognitive-behavioural and psycho-educational framework Standard care BDI-II; HADS; GHQ-12; MSIS; MSSE; EQ-5D
Cooper (2011) [30] BDI-II ≥ 14 but < 29; EDSS < 8.5; MMSE < 24; No psychological co-morbidities; Low suicide risk; No treatment from psychologist, psychotherapist or psychiatrist within last 3 months. Confirmed diagnosis of MS (McDonald criteria) Eight 50 minute computerised cognitive behavioural therapy sessions Standard care BDI-II; MSIS; SF-36; PHQ-9; GAD-7
  1. BDI: Beck Depression Inventory; EDSS: Expanded Disability Status Scale; GAD-7: Generalised Anxiety Disorder 7-item; GHQ-12: General Health Questionnaire 12-item; GNDS: Guy’s Neurological Disability Scale; HADS: Hospital Anxiety and Depression Scale; HRSD: Hamilton Rating Scale for Depression; MDD: Major Depressive Disorder; MMSE: Mini Mental State Examination; MSIS: Multiple Sclerosis Impact Scale; MSSE: Multiple Sclerosis Self-Efficacy Scale; PANAS-PA: Positive Affect subscale of the Positive and Negative Affect Scale; PHQ-9: Patient Health Questionnaire 9-item; POMS-DS: Profile of Mood States - Depression-Dejection Scale; SCID: Structured Clinical Interview for DSM-IV; SF-36: Short Form Health Survey.
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