CBT as an Effective Mood Therapy for Patients with MS Experiencing Fatigue: Federica Picariello, PhD


The postdoctoral researcher and health psychologist at King's College, London spoke at ECTRIMS 2022 about the relationship between mood and fatigue in patients with MS. [WATCH TIME: 2 minutes]

WATCH TIME: 2 minutes

“CBT is a great talking therapy, and it is very effective. But, it's a constellation of different techniques, that has an underlying overall treatment logic model—the way you think and the way you feel and what you do in response to the thoughts and emotions will lead you to act in certain ways that can contribute to how you feel. But the treatment protocol needs to be tailored to the presenting problem.”

One of the most common symptoms that individuals with multiple sclerosis (MS) experience is fatigue, which impacts their mental health quality of life (QoL). Recent data from a cohort of 2,104 individuals with MS, showed that the majority of the fatigue and mental QoL relationship was accounted for by depression as a mediator. The results displayed that the average fatigue score was 41.5 out of 63 based on a Fatigue Severity Scale and the average mental QoL score was 71.9 out of 100.1

Depression as a mediator with the fatigue-QoL relationship, mental QoL had 14.72 points lower (95% CI, –16.43 to –13.01; P <.001) for those clinically significant in fatigue based on the Structural Equation Models (SEM). Additionally in the SEM, depression accounted for 53.0% (–7.80; 95% CI, –9.03 to –6.57; P <.001). Physical activity being a mediator with the fatigue-QoL relationship, had mental QoL 10.89 points lower (95% CI, –12.47 to –9.32; P <.001) for those clinically significant in fatigue as physical activity accounted only for 4.4% as an indirect effect (–0.48; 95% CI, –0.81 to –0.14; P = .005).

Picariello, postdoctoral researcher, psychologist, King's College, London, an attendee from the 2022 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, from October 26-28, in Amsterdam, Netherlands, and sat down with NeurologyLive® to talk about the mental aspect of the disease burden with MS. She discussed the impact of fatigue on mental health in patients with MS, such as them experiencing depression and the added challenge that comes along with addressing it.

1. Fidao A, De Livera A, Nag N, Neate S, Jelinek GA, Simpson-Yap S. Depression mediates the relationship between fatigue and mental health-related quality of life in multiple sclerosis. Mult Scler Relat Disord. 2021;47:102620. doi:10.1016/j.msard.2020.102620
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