Comparative efficacy of non-pharmacological interventions on depression in people with multiple sclerosis: A...

Depression, a common psychological problem in multiple sclerosis (MS) patients, can exacerbate the deterioration of the disease and have an impact on the quality of life of MS. Non-pharmacological therapies are effective alternatives to pharmacological treatments. It is not clear which non-pharmacological therapies are most effective in improving depression in MS at present.

To compare the effectiveness of non-pharmacological interventions in enhancing depression in people with MS.

A total of seven databases were searched from the establishment of the database to June 2024. After literature screening and data extraction, the Cochrane Bias Assessment Tool 2.0 version of randomized controlled trials (RCTs) was used to evaluate the quality of the literature. A network meta-analysis was performed to evaluate the relative efficacy of the non-pharmacological interventions on depression. Statistical analysis was performed using R (version 4.3.2) and STATA 17.0 software.

A total of 33 RCTs involving seven non-pharmacological interventions (cognitive behavioral therapy, mindfulness therapy, acceptance of commitment therapy, exercise therapy, relaxation therapy, education, and computer-assisted cognitive rehabilitation) were included. The results of the network meta-analysis showed that cognitive-behavioral therapy (SMD = -4.04, 95%CrI = -6.80 to -1.45), exercise therapy (SMD= = -3.62, 95 % CrI= = -6.55 to -0.85), and education (SMD = -2.94, 95 % CrI = -5.69 to -0.25) were effective in improving depression in multiple sclerosis patients relative to the control group.

This study confirms that non-pharmacological interventions can improve depression in MS patients. Healthcare professionals can choose non-pharmacological therapies according to the specific conditions of MS patients to improve the depression of them and thus enhance their quality of life in future.