title: The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of a cognitive behavioral group-based intervention aimed at reducing depression and fostering quality of life and psychological well-being of multiple sclerosis patients through the promotion of identity redefinition, sense of coherence, and self-efficacy.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  Non-medical setting, external to the Multiple Sclerosis Clinic Centre.
  
  
  METHODS
  Eighty-two patients: 64% women; mean age 40.5, SD = 9.4; 95% with relapsing-remitting multiple sclerosis; Expanded Disability Status Scale (EDSS) between 1 and 5.5 were included in the study.
  
  
  METHODS
  Patients were randomly assigned to an intervention group (five cognitive behavioral group-based sessions, n = 41) or to a control group (three informative sessions, n = 41).
  
  
  METHODS
  Depression (CES-D), Quality of life (MSQOL revised), Psychological well-being (PANAS), Identity Motives Scale, Sense of Coherence (SOC), and Self Efficacy in Multiple Sclerosis.
  
  
  RESULTS
  Quality of life increased in the intervention group compared with the control at 6-months follow-up (mean change 0.72 vs. -1.76, p < 0.05). Well-being in the intervention group increased for males and slightly decreased for females at 6-months follow-up (mean change 6.58 vs. -0.82, p < 0.05). Contrasts revealed an increase in self-efficacy in the intervention group at posttreatment compared with the control (mean change 2.95 vs. -0.11, p < 0.05). Depression tended to lower, while identity and coherence increased in the intervention group compared with the control, though the differences were not significant.
  
  
  CONCLUSIONS
  Preliminary evidence suggests that intervention promotes patients' quality of life and has an effect on psychological well-being and self-efficacy.
authors.affiliation: 1Cosso Foundation, Pinerolo, Torino, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Graziano
authors.forename: Emanuela
authors.initials: E
authors.lastname: Calandri
authors.forename: Martina
authors.initials: M
authors.lastname: Borghi
authors.forename: Silvia
authors.initials: S
authors.lastname: Bonino
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology* / Q000534:rehabilitation; D017063:Outcome Assessment, Health Care; D011615:Psychotherapy, Group / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy; D055815:Young Adult
keywords: Multiple sclerosis; cognitive behavioral therapy; depression; group therapy; identity; quality of life; self-efficacy; sense of coherence; well-being