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Normative data for the Hospital Anxiety and Depression Scales (HADS) in multiple sclerosis
- Authors:
- ATKINS Lizzy, NEWBY Gavin, PIMM John
- Journal article citation:
- Social Care and Neurodisability, 3(4), 2012, pp.172-178.
- Publisher:
- Emerald
Depression and anxiety are common in individuals with multiple sclerosis (MS). This study aimed to investigate the use of the Hospital Anxiety and Depression Scales (HADS) as a useful tool for measuring anxiety and depression in people with MS who live in the community. Another aim was to provide normative data specific to MS to help in the assessment of anxiety and depression for clinicians and researchers. The study was part of a larger community postal survey investigating the relationship between mood and self-reported cognitive difficulties in MS. A total of 144 individuals with MS in this study completed the HADS. The findings showed that individuals with MS report significantly greater levels of anxiety and depression than a healthy population, with prevalence rates of moderate/severe anxiety of 32.4% and prevalence rates of moderate/severe depression of 12.5%. The HADS had good levels of internal reliability, providing evidence of the suitability of the HADS in this population. Raw scores and percentile equivalents for use with MS patients are reported.
Future-directed thinking and depression in relapsing-remitting multiple sclerosis
- Authors:
- MOORE Anna C., et al
- Journal article citation:
- British Journal of Health Psychology, 11(4), November 2006, pp.663-675.
- Publisher:
- Wiley
Research has shown that depression is associated with a view of the future characterized by reduced anticipation of future positive experiences, but not necessarily increased anticipation of future negative experiences. The aim of the present study was to investigate how participants with relapsing-remitting multiple sclerosis (MS) anticipated their future in terms of positive and negative events. A mixed design compared three groups of participants on a measure of future thinking using an adapted verbal fluency paradigm. Depressed MS participants (N=14), non-depressed MS participants (N=28) and healthy control participants (N=26) were assessed on their ability to generate future positive and negative experiences. A content analysis was also conducted on the responses generated by the MS depressed and MS non-depressed groups according to whether or not they were related to MS. The MS depressed group anticipated significantly fewer future positive events than the healthy control group and the MS non-depressed group. The three groups did not differ in the total numbers of anticipated future negative events, though the MS depressed group did anticipate a significantly higher proportion of MS-related negative events. Like depressed but physically healthy individuals, the MS depressed group was characterized by a lack of positive thoughts about the future, rather than an increased number of negative thoughts. The clinical implications of these findings are discussed along with recommendations for future research.
Enhancing the mental well-being of people with multiple sclerosis
- Authors:
- ASKEY-JONES Sally, et al
- Journal article citation:
- Nursing Times, 24.2.09, 2009, p.22.
- Publisher:
- Nursing Times
Briefly reports on a services that aims to enhance the mental and emotional wellbeing of people who have multiple sclerosis. The service provides assessment and treatment using medication, cognitive behavioural therapy (CBT) and psychosocial interventions. Patients also receive education that helps them empower them to take control over their lives.
Symptoms of depression in older adults with multiple sclerosis (MS): comparison with a matched sample of younger adults
- Authors:
- KNEEBONE I. I., DUNMORE E. C., EVANS E.
- Journal article citation:
- Aging and Mental Health, 7(3), May 2003, pp.182-185.
- Publisher:
- Taylor and Francis
The study considered for the first time depression in older adults with multiple sclerosis (MS). Depression symptom scores of 27 persons aged over 65 years who were part of a large study of persons with MS (n1/4529), were compared with those of a matched sample of younger adults from the same study. The association between cognitive (attitudinal) variables known to explain significant variance in depressive symptoms in younger adults with MS was then considered in the older adult sample. Consistent with findings from studies with general community samples, older adults with MS reported significantly fewer depressive symptoms than younger adults with MS. The relationship between cognitive variables and depressive symptoms found previously in younger adults was also evident for the older adults. Multiple sclerosis related helplessness was found to be significantly higher in older as opposed to younger adults with MS, the opposite of what was predicted given the differences between the groups in depression scores. Differences in the cognitive variables do not appear to explain the differences between older and younger adults with MS in terms of depressive symptoms. This finding offers support for the view that a decrease in emotional responsiveness may explain differences in depressive symptoms between younger and older adults with MS, rather than this being the result of differences in emotional control exerted via cognitive means.
Failing to publish outcomes data
- Author:
- SEGAL Julia
- Journal article citation:
- Therapy Today, 22(6), July 2011, pp.21-24.
- Publisher:
- British Association for Counselling and Psychotherapy
The author previously worked part time in an NHS setting providing counselling to clients with many different physical conditions and their families, with people with multiple sclerosis (MS) making up about half of the client list. For a year from November 2008 she collected outcomes data from her clients after each session using the Hospital Anxiety and Depression Scale (HADS) and CORE10. Since then, she has been made redundant and feels some guilt for having failed to provide convincing evidence of the value of the service. This article describes what happened when she began to collect data in the hope of contributing to the evidence base for counselling. In particular it considers the difficulties of collecting data from clients with neurological conditions whose minds suffer from constant onslaughts by disease processes. The findings demonstrate that 60% of the clients could be seen to improve over the year. In the face of a deteriorating neurological condition, simply ‘maintaining the status quo’ can be important. Some clients who did not appear to be gaining much benefit from the counselling were actually the most enthusiastic in favour of counselling.
A randomized group intervention trial to enhance mood and self-efficacy in people with multiple sclerosis
- Authors:
- RIGBY S. A., THORNTON E. W., YOUNG C. A.
- Journal article citation:
- British Journal of Health Psychology, 13(4), November 2008, pp.619-631.
- Publisher:
- Wiley
This study aimed to document mood, self-efficacy, and resiliency in people with multiple sclerosis (MS) following a brief group psychological intervention, and to examine whether benefits were greater than those derived from provision of education or group social interaction. A randomized controlled intervention trial assessing outcomes at five time points over a 1-year follow-up was used. Participants with MS were assigned to one of three groups: one receiving brief group psychological intervention (PG) comprising three 90 minute cognitive behavioural sessions supported by an Information Booklet dealing with mental and emotional issues relating to MS; a group provided only with educational material - the information booklet group (IBG); and a group who not only received the booklet but also participated in non-structured social discussion (SDG) sessions similar in length and number to PG participants. Outcomes were documented using questionnaires. Outcomes were assessed using area under the curve (AUC) analysis: a summary measure that considers individual changes serially over time to provide a more meaningful picture than the one based on single time points. Ninety participants were followed up over the 12-month post-intervention, and their data are included in the analysis. Analyses indicated benefits in all outcome dimensions for the psychotherapeutic (PG) and social discussion groups (SDG) relative to the IBG group, but no differences between PG and SDG. The study indicates benefits from psychosocial intervention compared with bibliotherapy, with some additional benefit from psychological intervention compared with a social discussion group. Results suggest that much of the benefit may derive from non-specific therapeutic components. Without psychosocial intervention, the psychological status of people with MS worsened over time.
Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials
- Authors:
- BELTMAN Matthijs W, VOSHAAR Richard C. Oude, SPECKENS Anne E.
- Journal article citation:
- British Journal of Psychiatry, 197(1), July 2010, pp.11-19.
- Publisher:
- Cambridge University Press
This article describes a meta-analysis of the effectiveness of cognitive-behavioural therapy (CBT) for depression in people with an underlying somatic disease. The hypothesis was that there would be higher efficacy in people who met predefined criteria for depression, so separate meta-analyses were conducted for studies of participants with depressive disorder from those with depressive symptoms. A literature search for relevant studies was conducted in several databases up to October 2008. Twenty nine papers that described randomised controlled studies meeting the inclusion criteria were selected. The results showed that cognitive–behavioural therapy was superior to control conditions, with larger effects in studies restricted to participants with depressive disorder than in studies of participants with depressive symptoms. Subgroup analyses showed that CBT was not superior to other psychotherapies. The article concludes that cognitive–behavioural therapy significantly reduces depressive symptoms in people with a somatic disease, especially in those who meet the criteria for a depressive disorder.
Therapeutic aspects of cannabis and cannabinoids
- Author:
- ROBSON Philip
- Journal article citation:
- British Journal of Psychiatry, 178, February 2001, pp.107-115.
- Publisher:
- Cambridge University Press
This article assesses the therapeutic profile of cannabis and cannabinoids. Using Medline search, references supplied by DOH and others, and personal communications. Cannabis and some cannabinoids are effective anti-emetics and analgesics and reduce intra-ocular pressure. There is evidence of symptom relief and improved well-being in selected neurological conditions, AIDS and certain cancers. Cannabinoids may reduce anxiety and improve sleep.