A randomised controlled trial of internet-delivered cognitive behavioural therapy targeting symptoms of depression, anxiety and disability in adults with multiple sclerosis

Background
Assessed the efficacy of a transdiagnostic internet-delivered psychological intervention for depression, anxiety and disability in adults with multiple sclerosis (MS).

Methods
Randomised controlled trial of 142 participants with a confirmed diagnosis of MS were allocated to either an immediate treatment group (n = 73) or treatment-as-usual waitlist control (n = 69). The intervention, the Wellbeing Neuro Course, was based on Cognitive Behavioural Therapy and included six online lessons delivered over 10 weeks with the option of support from a psychologist via email and telephone. Primary outcomes were symptoms of depression (PHQ-9), anxiety (GAD-7), and disability (WHODAS 2.0).

Results
One hundred and thirty-three participants commenced the trial (treatment n = 72; control n = 61) and were included in intention-to-treat analyses. Significant between-group differences were observed in depression (PHQ-9; g = 0.54; 23% average [avg.] symptom reduction), anxiety (GAD-7; g = 0.37; 30% avg. reduction) and disability (WHODAS 2.0; g = 0.28; 14% avg. reduction) at post-treatment favouring treatment (all ps < 0.05). Treatment-related effects were maintained at 3 and 12-month follow-up. No adverse treatment events were reported.

Conclusions
Internet-delivered transdiagnostic psychological interventions appear to be an acceptable and efficacious option for providing accessible psychological care for adults with MS.