Journal explores efficacy of iCBT in reducing depressive symptoms for patients with MS

A recent study published in The Lancet explores an internet-delivered cognitive behavioural therapy programme aiming to reduce depressive symptoms in patients with multiple sclerosis, with the research team concluding that this “remote access, scalable intervention increases the therapeutic options in this patient group and could help to overcome treatment barriers”.

The authors carried out a a controlled trial of an iCBT programme at five academic centres in Germany and the USA. Patients with a neurologist-confirmed diagnosis of MS and depressive symptoms were randomly assigned to receive treatment as usual, plus one of two versions of an online iCBT programme – either taking themselves through the programme, or therapist-guided. The programme uses a stimulated dialogue approach to guide participants through ten modules tailored to individuals, with their responses to the dialogue determining their path. In a control condition, participants received treatment as usual and were offered access to the iCBT programme after six months. The Beck Depression Inventory-II was then used to measure the severity of depressive symptoms at week 12.

The main findings included that “both versions of the iCBT programme significantly reduced depressive symptoms compared with the control group”. Authors noted that “clinically relevant worsening of depressive symptoms was observed in three participants in the control group, one in the stand-alone iCBT group, and none in the guided iCBT group”.

Overall, the researchers concluded that the trial “provides evidence for the efficacy of this multiple sclerosis-specific online depression management tool as a stand-alone or guided application” to reduce depressive symptoms in this context.

One acknowledgement is that some differences were observed in baseline values of the Beck-Depression Inventory-II scores between trial groups, with the researchers noting that future trials using iCBT for this condition could “consider using stratified randomisation to minimise the probability of baseline differences”. They pointed out that acerage scores at the end of treatment remained higher than the clinical threshold for depression, indicating that “full remission is difficult to reach with an internet-based tool in many cases”.

Citation: Prof Stefan M Gold, Prof Tim Friede, Bjorn Meyer, Prof Rona Moss-Morris, Joanna Hudson, Susanna Asseyer, Judith Bellman-Strobl, Andreas Leisdon, Leonie IßelsKristin RitterDavid SchymainskiHayley PomeroySharon G LynchJulia S CozartJoan ThelenCristina A F RománMargaret CaddenErin GutyStephanie LauJana PöttgenCaren RamienSusan Seddiq-ZaiAnna-Maria KloidtJohannes WieditzIris-Katharina PennerFriedemann PaulNancy L SicotteJared M BrucePeter A ArnettChristoph Heesen. Internet-delivered cognitive behavioural therapy programme to reduce depressive symptoms in patients with multiple sclerosis: a multicentre, randomised, controlled, phase 3 trial, Lancet Digital Health, Volume 5, Issue 10, October 2023. DOI:

Other journals recently covered by HTN include an exploration of healthcare data infrastructure and subsequent recommendations; an evaluation of the potential for fusion of data collected from wearables in allowing a more holistic approach to health monitoring; and an examination of the role of digital fellowships in facilitating digital transformation in healthcare systems.

We also recently welcomed Dr Joseph Firth, senior research fellow at the University of Manchester and honorary fellow at Greater Manchester Mental Health NHS Foundation Trust and Western Sydney University, for a discussion on his research into digital lifestyle interventions in mental healthcare.