The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: a randomized controlled trial

Clin Rehabil. 2014 Mar;28(3):264-74. doi: 10.1177/0269215513501525. Epub 2013 Sep 6.


Objective: To evaluate the effectiveness of a cognitive behavioral group-based intervention aimed at reducing depression and fostering quality of life and psychological well-being of multiple sclerosis patients through the promotion of identity redefinition, sense of coherence, and self-efficacy.

Design: A randomized controlled trial.

Setting: Non-medical setting, external to the Multiple Sclerosis Clinic Centre.

Subjects: Eighty-two patients: 64% women; mean age 40.5, SD = 9.4; 95% with relapsing-remitting multiple sclerosis; Expanded Disability Status Scale (EDSS) between 1 and 5.5 were included in the study.

Interventions: Patients were randomly assigned to an intervention group (five cognitive behavioral group-based sessions, n = 41) or to a control group (three informative sessions, n = 41).

Main measures: Depression (CES-D), Quality of life (MSQOL revised), Psychological well-being (PANAS), Identity Motives Scale, Sense of Coherence (SOC), and Self Efficacy in Multiple Sclerosis.

Results: Quality of life increased in the intervention group compared with the control at 6-months follow-up (mean change 0.72 vs. -1.76, p < 0.05). Well-being in the intervention group increased for males and slightly decreased for females at 6-months follow-up (mean change 6.58 vs. -0.82, p < 0.05). Contrasts revealed an increase in self-efficacy in the intervention group at posttreatment compared with the control (mean change 2.95 vs. -0.11, p < 0.05). Depression tended to lower, while identity and coherence increased in the intervention group compared with the control, though the differences were not significant.

Conclusions: Preliminary evidence suggests that intervention promotes patients' quality of life and has an effect on psychological well-being and self-efficacy.

Keywords: Multiple sclerosis; cognitive behavioral therapy; depression; group therapy; identity; quality of life; self-efficacy; sense of coherence; well-being.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cognitive Behavioral Therapy / methods*
  • Depression / etiology
  • Depression / therapy*
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Multiple Sclerosis / psychology*
  • Multiple Sclerosis / rehabilitation
  • Outcome Assessment, Health Care
  • Psychotherapy, Group / methods
  • Quality of Life / psychology*
  • Self Efficacy
  • Young Adult