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Internet-based therapy can reduce depressive symptoms in people with multiple sclerosis

A study co-authored by a KU Medical Center researcher and published in Lancet Digital Health found that an online platform for cognitive behavioral therapy improved the mental health of people with MS and depression.

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People with neurological disorders such as MS are three to four times more likely to have depression than the general population.

A new kind of therapy might soon be able to help patients with multiple sclerosis (MS) who struggle with depression, according to a study recently published in Lancet Digital Health and co-authored by Sharon Lynch, Ph.D., neurology professor and director of the MS Achievement Center at the University of Kansas Medical Center.

The program at the center of the study, called Amiria, is an online platform for delivering cognitive behavioral therapy. It differs from teletherapy in that it’s completely self-guided, allowing patients to move at their own pace from the comfort of their homes, Lynch said.

Amiria was developed from a generic internet-based cognitive behavioral therapy program called Deprexis, which is for anyone who struggles with depression. Lynch and her fellow researchers saw an opportunity to help patients with MS and depression by creating a tool based on Deprexis but with content tailored to coping with the specific stresses of chronic diseases.

“Particularly when it comes to things like depression, which still has a stigma around it, if you don't have to go see a psychologist and let everybody in town know that you're having problems, but instead, you can [be treated] from the safety and privacy of your own home, it makes it much more likely that people will do it,” Lynch said.

Depression is particularly common for people who have MS, Lynch said. Depression is three to four times as likely to impact someone with a neurological disorder, such as MS, than the general population, according to the study.

“There are some who believe depression is actually an organic piece of MS, and there are some who believe that it's not so much organic as it is just the reality of chronic illness, and I think it's a combination of the two,” Lynch said.

The study, led by Stefan Gold, Ph.D., a researcher at Charite University Hospital in Berlin, encompassed five research sites in the U.S. and Germany and enrolled nearly 300 participants. The site in Kansas City enrolled about 50 participants, Lynch said.

During the study, one group of patients received only the Amiria program, while another group received Amiria and had a psychologist reach out to them to check in and encourage them to complete the program. The control group received their usual treatment, without access to Amiria. The severity of all participants’ depressive symptoms was measured using the Beck Depression Inventory-II questionnaire at the beginning of the study and after 12 weeks.

At the end of 12 weeks, both groups receiving the Deprexis-based Amiria program experienced a significant reduction in their depression symptoms compared with the control group. The improvement in mental health was about equal between the two Amiria groups, Lynch said.

One benefit of such an online-based program is that patients can access help quickly, instead of waiting to get an appointment with a provider, said Jared Bruce, Ph.D., director of psychiatric research at the University of Missouri-Kansas City, who also co-authored the study.

“There’s a real lack of providers, not just in rural areas, but also in urban areas,” Bruce said. “Waitlists are long everywhere to see somebody for help with depression. I think that these kinds of computer-based [programs] will be integrated over time, and they are going to help a lot of people.”

The program could also help remove treatment barriers for patients who might not be able to afford regular visits to a therapist, Lynch said. Although the cost has not been finalized, Lynch said it could be offered to patients for less than $60 per month.

Lynch said that with this research completed, the next step for Amiria is to make it commercially available. Although the timeline for that is currently unknown, Lynch is hopeful it will be soon.

“It’s really important that people feel like that they can do something to improve their quality of life, whether they have MS or not,” Lynch said. “There are lots of things to do — eat healthy, exercise — but you also have to take care of your mental health.”

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