title: Behavioral interventions in multiple sclerosis: a biopsychosocial perspective.
abstract: Managing uncertainty is a major challenge associated with the diagnosis of multiple sclerosis (MS). In addition to physical symptoms, neuropsychiatric symptoms are highly prevalent in this disease. Depression in particular is more common in MS than in other chronic diseases. While substantial achievements have been made in the therapy of MS and an increasing number of immunomodulatory treatments are now available, the long-term benefits of these are still a matter of debate. Importantly, while the approved therapies show good efficacy on inflammatory lesions and relapse rate, and may slow certain aspects of disease progression, improvements in function have rarely been reported. On the other hand, behavioral interventions have recently been shown to significantly improve fatigue and depression as well as motor function. In addition, recent evidence suggests that group education or face-to-face behavioral interventions may decrease inflammatory disease activity (such as relapse rate or lesion formation measured by MRI). Therefore, behavioral interventions not only ameliorate symptoms but may have the potential to modify the disease process itself.
authors.affiliation: University Medical Center Hamburg-Eppendorf, Institute for Neuroimmunology and Clinical MS Research and Department of Neurology, Hamburg, Germany. heesen@uke.uni-hamburg.de
authors.forename: C
authors.initials: C
authors.lastname: Heesen
authors.forename: S
authors.initials: S
authors.lastname: Köpke
authors.forename: J
authors.initials: J
authors.lastname: Kasper
authors.forename: J
authors.initials: J
authors.lastname: Poettgen
authors.forename: A
authors.initials: A
authors.lastname: Tallner
authors.forename: D C
authors.initials: DC
authors.lastname: Mohr
authors.forename: S M
authors.initials: SM
authors.lastname: Gold
mesh_terms: D000818:Animals; D001522:Behavior, Animal; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D019317:Evidence-Based Medicine; D015444:Exercise; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D018696:Neuroprotective Agents / Q000627:therapeutic use; D012944:Social Support; D013177:Sports
chemical_list: D018696:Neuroprotective Agents