title: Internet-based self-help treatment for depression in multiple sclerosis: study protocol of a randomized controlled trial.
abstract: BACKGROUND
  Depression in MS patients is frequent but often not treated adequately. An important underlying factor may be physical limitations that preclude face-to-face contact. Internet-based treatment showed to be effective for depressive symptoms in general and could thus be a promising tool for treatment in MS.
  
  
  METHODS
  Here, we present a study protocol to investigate the effectiveness of a 5 week Internet-based self-help problem solving treatment (PST) for depressive symptoms in MS patients in a randomized controlled trial. We aim to include 166 MS patients with moderate to severe depressive symptoms who will be randomly assigned to an Internet-based intervention (with or without supportive text-messages) or waiting list control group. The primary outcome is the change in depressive symptoms defined by a change in the sum score on the Beck Depression Inventory (BDI-II). Secondary outcomes will include measures of anxiety, fatigue, cognitive functioning, physical and psychological impact of MS, quality of life, problem solving skills, social support, mastery, satisfaction and compliance rate. Assessments will take place at baseline (T0), within a week after the intervention (T1), at four months (T2) and at ten months follow-up (T3: only the intervention group). The control group will be measured at the same moments in time. Analysis will be based on the intention-to-treat principle.
  
  
  CONCLUSIONS
  If shown to be effective, Internet-based PST will offer new possibilities to reach and treat MS patients with depressive symptoms and to improve the quality of care.
  
  
  BACKGROUND
  The Dutch Cochrane Center, NTR2772.
authors.affiliation: Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest, A. J. Ernststraat 1187, Amsterdam, HL 1081, The Netherlands. r.boeschoten@ggzingeest.nl
authors.forename: Rosa E
authors.initials: RE
authors.lastname: Boeschoten
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
authors.forename: Bernard M J
authors.initials: BM
authors.lastname: Uitdehaag
authors.forename: Chris H
authors.initials: CH
authors.lastname: Polman
authors.forename: Emma H
authors.initials: EH
authors.lastname: Collette
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: Patricia
authors.initials: P
authors.lastname: van Oppen
mesh_terms: D002985:Clinical Protocols; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology; D017060:Patient Satisfaction; D011340:Problem Solving; D011613:Psychotherapy / Q000379:methods*; D019114:Remote Consultation / Q000379:methods*; D012107:Research Design; D012648:Self Care; D012944:Social Support; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome