Not for everyone: Factors influencing who receives psychotherapy in people with multiple sclerosis

Mult Scler Relat Disord. 2024 Dec 21;94:106245. doi: 10.1016/j.msard.2024.106245. Online ahead of print.

ABSTRACT

BACKGROUND: Although depression and anxiety are common in people with multiple sclerosis (pwMS), access to psychotherapy remains limited.

OBJECTIVES: This study aimed to identify clinical factors that predict use of psychotherapy among pwMS.

METHODS: From a retrospective chart review of a tertiary neuropsychiatry clinic in Toronto, Canada, data were obtained for 267 pwMS who received neuropsychiatric treatment (either with antidepressants or psychotherapy). Candidate predictor variables included demographics (e.g. age, sex), disease-related factors (e.g. disease duration, MS subtype, Expanded Disability Status Scale (EDSS) score), symptom data (e.g. Hospital Anxiety and Depression Scale sub-scales for anxiety and depression, five-item Modified Fatigue Impact Scale), and other treatment use (e.g. disease-modifying therapies, psychotropic medications). A backward stepwise logistic regression analysis identified predictors of psychotherapy use (p<.05).

RESULTS: Mean age was 46.97 years, 70.41 % were female, median EDSS was 2.50, 63.30 % had relapsing illness, and 22.47 % received psychotherapy. Increased EDSS scores (OR=0.74, 95 % CI 0.58-0.95, p=.02) and prolonged disease duration (OR=0.94, 95 % CI 0.89-0.99, p=.03) predicted decreased use of psychotherapy.

CONCLUSIONS: Neurological disability and disease duration may influence psychotherapy use among pwMS. Studies are now needed to evaluate contributors to these associations to expand access to non-pharmacological treatments for pwMS.

PMID:39764908 | DOI:10.1016/j.msard.2024.106245