The role of psychologists in the treatment of multiple sclerosis

Abstract

Multiple sclerosis (MS) is the most common progressive neurological disorder affecting individuals between 15 and 50 years of age. Because of its neuropathological process, MS causes multiple symptoms that impact the physical, social, vocational, and psychological well-being of patients. Within the comprehensive care approach to treatment of these patients, psychologists provide multiple services. In the present paper, we summarize current research on psychological treatments of symptoms common to patients with MS. Investigators have advocated use of many types of individual and group psychotherapeutic approaches to treat psychiatric symptoms caused by MS, but there are few controlled outcome studies. The existing controlled outcome studies indicate that cognitive behavioral, insight-oriented, and stress management group therapies are effective, as are individual approaches utilizing stress inoculation training and pharmacotherapy. Reports concerning biofeedback have used single case designs and provide initial evidence that this technique is useful for treating fecal incontinence and retention, postural instability, and weaning from a respirator. MS symptoms that may also be amenable to psychological treatments include chronic pain, weight management, and sexual dysfunctions, although there are currently no outcome studies that verify the efficacy of these treatments when used with MS patients. Because of the multiple symptoms produced by MS, clinicians often need to modify delivery of services. In this paper, we provide specific recommendations to help clinicians tailor their treatments to the special needs of patients with MS. Finally, we provide suggestions for future research.