Psychotherapy in treatment and rehabilitation of patients with multiple sclerosis

Nikolaev E.L.; Poluéktov M.G.; Vasil'eva N.V.; Golenkov A.V.

doi:https://doi.org/10.17116/jnevro2017117121132-140

Close metadata

Recommended articles:

Hormonal contraception methods and multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(1):24-30

Epidemiology of multiple sclerosis in the city of Novosibirsk. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(1):119-127

Comparing the efficacy of divozilimab and second-line treatments for relapsing-remitting multiple sclerosis in the Russian Federation: a systematic review and network meta-analysis. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(2):58-68

Sequential use of botulinum toxin A and bovhyaluronidase azoximer in the correction of post-stroke spasticity. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(2):80-85

Cognitive vascular disorders and morphometric parameters of the prefrontal, dorsolateral cortex and thalamus in post-stroke patients. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(2):91-95

Exercise therapy in outpatient rehabilitation programmes for patients with comorbid digestive pathology in colon cancer and chronic pancreatitis. (Open randomized controlled trial). Problems of Balneology, Physiotherapy and Exercise Therapy. 2024;(6-2):5-12

Assessment of the quality of life of patients after dental surgeries using kinesiotaping and infrared laser therapy. Problems of Balneology, Physiotherapy and Exercise Therapy. 2024;(6-2):110-116

Nutrition correction in the complex therapy and rehabilitation of the posttraumatic stress disorder. Russian Journal of Preventive Medicine. 2025;(2):114-119

Digital dental approach in rehabilitation of a patient treated for unilateral ankylosis of a temporomandibular joint using condylotomy. Stomatology. 2025;(1):9-16

Hand burns in pediatrics. Pirogov Russian Journal of Surgery. 2025;(3):96-106

Abstract:

Presented is a review of the use of psychotherapy and psychological intervention methods in treatment and rehabilitation of patients with multiple sclerosis (MS). Main indications for psychotherapy in MS are anxiety and depression, asthenia, movement disorders, cognitive decline or sleep disturbances. The applied methods of psychotherapy refer to behavioral, cognitive, humanistic, combined or alternative approaches. Individual and group sessions are most frequently used forms of psychotherapy. Positive effects of psychotherapy in MS patients are confirmed by data of randomized studies and neuroimaging. Psychotherapy should be included into complex multidisciplinary programs of treatment and rehabilitation of MS patients.

Keywords:

psychotherapy

multiple sclerosis

rehabilitation

Authors:

Nikolaev E.L.

Chuvashskiĭ gosudarstvennyĭ universitet im. I.N. Ul'ianova, Cheboksary

Poluéktov M.G.

Kurs somnologii pri kafedre nervnykh bolezneĭ fakul'teta poslevuzovskogo professional'nogo obrazovaniia Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova

Vasil'eva N.V.

P.N. Kashkin Research Institute of Medical Micology State educational institution of higher professional education "Sankt Peterburg Medical Academy of Postgraduate Education", Federal Agency for Healthcare and Social Development

Golenkov A.V.

Chuvashskiĭ gosuniversitet im. I.N. Ul'ianova, Cheboksary;
Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova, Moskva

Close metadata

References:

Lovera J, Reza T Stress in multiple sclerosis: review of new developments and future directions. Curr Neurol Neurosci Rep. 2013;3:398. https://doi.org/10.1007/s11910-013-0398-4
Mohr DC, Lovera J, Brown T, Cohen B, Neylan T, Henry R, Siddique J, Jin L, Daikh D, Pelletier D. A randomized trial of stress management for the prevention of new brain lesions in MS. Neurology. 2012;79(5):412-419. https://doi.org/10.1212/WNL.0b013e3182616ff9
Heesen C, Köpke S, Kasper J, Poettgen J, Tallner A, Mohr DC, Gold SM. Behavioral interventions in multiple sclerosis: a biopsychosocial perspective. Expert Rev Neurother. 2012;12:1089-1100. https://doi.org/10.1586/ern.12.103
Spitzer C, Bouchain M, Winkler LY, Wingenfeld K, Gold SM, Grabe HJ, Barnow S, Otte C, Heesen C. Childhood trauma in multiple sclerosis: a case-control study. Psychosom Med. 2012;74:312-318. https://doi.org/10.1097/PSY.0b013e31824c2013
Reznikova TN, Terent’eva IYu, Seliverstova NA, Khomenko YuG. A psychological study of patients with multiple sclerosis. Zh Nevrol Psikhiatr Im. S.S. Korsakova. 2007;107(7):36-42. (In Russ.)
Matveeva TV, Mendelevich VD, Rechanik DP. Struktura psikhicheskikh rasstroistv u bol’nykh rasseyannym sklerozom. Nevrologicheskii vestnik. 2002;34:1-2:69-73. (In Russ.)
Subbotin AV, Semenov VA, Getmanenko IM, Korotkevich NA, Aref’eva EG. Ispol’zovanie psikhodiagnosticheskikh metodov pri psikhokorrektsionnoi rabote s bol’nymi rasseyannym sklerozom. Byulleten’ sibirskoi meditsiny (tematicheskii vypusk). 2009:1:120-125. (In Russ.)
Cooper CL, Hind D, Parry GD, Isaac CL, Dimairo M, O’Cathain A, Rose A, Freeman JV, Martin L, Kaltenthaler EC, Thake A, Sharrack B. Computerised cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: external pilot trial. Trials. 2011;12:259. https://doi.org/10.1186/1745-6215-12-259
Artemiadis AK, Vervainioti AA, Alexopoulos EC, Rombos A, Anagnostouli MC, Darviri C. Stress management and multiple sclerosis: a randomized controlled trial. Arch Clin Neuropsychol 2012;27(4):406-416. https://doi.org/10.1093/arclin/acs039
Moss-Morris R, McCrone P, Yardley L, van Kessel K, Wills G, Dennison L. A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. Behav Res Ther. 2012;50(6):415-421. https://doi.org/10.1016/j.brat.2012.03.001
Knoop H, van Kessel K, Moss-Morris R. Which cognitions and behaviours mediate the positive effect of cognitive behavioural therapy on fatigue in patients with multiple sclerosis? Psychol Med. 2012;42(1):205-213. https://doi.org/10.1017/S0033291711000924
Hart SL, Vella L, Mohr DC. Relationships among depressive symptoms, benefit-finding, optimism, and positive affect in multiple sclerosis patients after psychotherapy for depression. Health Psychol. 2008;27(2):230-238. https://doi.org/10.1037/0278-6133.27.2.230
Smith MM, Arnett PA. Perfectionism and physical disability predict depression in multiple sclerosis. J Psychosom Res. 2013;75:187-189. https://doi.org/10.1016/j.jpsychores.2013.06.001
Dayapoğlu N, Tan M. Evaluation of the effect of progressive relaxation exercises on fatigue and sleep quality in patients with multiple sclerosis. J Altern Complement Med. 2012;18(10):983-987. https://doi.org/10.1089/acm.2011.0390
Thomas S, Thomas PW, Kersten P, Jones R, Green C, Nock A, Slingsby V, Smith AD, Baker R, Galvin KT, Hillier C. A pragmatic parallel arm multi-centre randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based fatigue management programme (FACETS) for people with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2013; 84(10):1092-1099. https://doi.org/10.1136/jnnp-2012-303816
Thomas S, Thomas PW, Nock A, Slingsby V, Galvin K, Baker R, Moffat N, Hillier C. Development and preliminary evaluation of a cognitive behavioural approach to fatigue management in people with multiple sclerosis. Patient Educ Couns. 2010;78(2):240-249. https://doi.org/10.1016/j.pec.2009.07.001
Dennison L, Moss-Morris R. Cognitive-behavioral therapy: what benefits can it offer people with multiple sclerosis? Expert Rev Neurother. 2010;10:1383-1390. https://doi.org/10.1586/ern.10.111
Moss-Morris R, Dennison L, Landau S, Yardley L, Silber E, Chalder T. A randomized controlled trial of cognitive behavioral therapy (CBT) for adjusting to multiple sclerosis (the saMS trial): does CBT work and for whom does it work? J Consult Clin Psychol. 2013;81(2):251-262. https://doi.org/10.1037/a0029132
Baron KG, Corden M, Jin L, Mohr DC. Impact of psychotherapy on insomnia symptoms in patients with depression and multiple sclerosis. J Behav Med. 2011;34(2):92-101. https://doi.org/10.1007/s10865-010-9288-2
Brenk A, Laun K, Haase CG. Short-term cognitive training improves mental efficiency and mood in patients with multiple sclerosis. Eur Neurol. 2008;60(6):304-309. https://doi.org/10.1159/000157885
Rosti-Otajärvi E, Mäntynen A, Koivisto K, Huhtala H, Hämäläinen P. Patient-related factors may affect the outcome of neuropsychological rehabilitation in multiple sclerosis. J Neurol Sci. 2013;334(1-2):106-111. https://doi.org/10.1016/j.jns.2013.07.2520
Rosti-Otajärvi E., Mäntynen A., Koivisto K., Huhtala H., Hämäläinen P. Neuropsychological rehabilitation has beneficial effects on perceived cognitive deficits in multiple sclerosis during nine-month follow-up. J Neurol Sci. 2013;334(1-2):154-160. https://doi.org/10.1016/j.jns.2013.08.017
Ghafari S, Ahmadi F, Nabavi M, Anoshirvan K, Memarian R, Rafatbakhsh M. Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. J Clin Nurs. 2009;18(15): 2171-2179. https://doi.org/10.1111/j.1365-2702.2009.02787.x
Psikhoterapevticheskaya entsiklopediya. Ed. Karvasarskii BD. SPb: Piter; 2006. (In Russ.)
Fischer A, Heesen C, Gold SM. Biological outcome measurements for behavioral interventions in multiple sclerosis. Therapeutic Advances in Neurological Disorders. 2011;4(4):217-229. https://doi.org/10.1177/1756285611405252
Kuznetsova LA, Malkova NA, Shubina OS, Verevkin EG, Dolgova MV. Biopovedencheskaya terapiya rasseyannogo skleroza. Byulleten’ SO RAMN. 2004;3:92-97. (In Russ.)
Kuznetsova LA. Issledovanie effektivnosti biopovedencheskoi terapii v lechenii bol’nykh rasseyannym sklerozom. [avtoreferat]. Novosibirsk. 2007. (In Russ.) http://medical-diss.com/medicina/issledovanie-effektivnosti-biopovedencheskoy-terapii-v-lechenii-bolnyh-rasseyannym-sklerozom
Churyukanov MV, Alekseev VV, Kukushkin NN, Yakhno NN. Psikhologicheskie osobennosti patsientov s tsentral’nym bolevym sindromom pri rasseyannom skleroze. Nevrologiya, neiropsikhiatriya, psikhosomatika. 2011;2:42-45. (In Russ.)
Nordin L, Rorsman I. Cognitive behavioural therapy in multiple sclerosis: a randomized controlled pilot study of acceptance and commitment therapy. J Rehabil Med. 2012;44(1):87-90. https://doi.org/10.2340/16501977-0898
Jongen PJ, Ter Horst AT, Brands AM. Cognitive impairment in multiple sclerosis. Minerva Med. 2012;103(2):73-96.
Pugovkina OD. Minfulness-based cognitive therapy: kognitivnaya psikhoterapiya, osnovannaya na osoznannosti, v lechenii khronicheskoi depressii. Sovremennaya terapiya psikhicheskikh rasstroistv. 2014;2:26-31. (In Russ.)
Fjorback LO. Mindfulness and bodily distress. Dan Med J. 2012;59(11):4547.
Grossman P, Kappos L, Gensicke H, D’Souza M, Mohr DC, Penner IK, Steiner C. MS quality of life, depression, and fatigue improve after mindfulness training: a randomized trial. Neurology. 2010;75(13):1141-1149. https://doi.org/10.1212/WNL.0b013e3181f4d80d
Simpson R, Booth J, Lawrence M, Byrne S, Mair F, Mercer S. Mindfulness based interventions in multiple sclerosis — a systematic review. BMC Neurol. 2014;14:15. https://doi.org/10.1186/1471-2377-14-15
Pezeshkian N. Psikhosomatika i pozitivnaya psikhoterapiya. M.: Meditsina; 1996. (In Russ.)
Schmid W, Aldridge D. Active music therapy in the treatment of multiple sclerosis patients: a matched control study. J Music Ther. 2004;41(3):225-140.
Aldridge D, Schmid W, Kaeder M, Schmidt C, Ostermann T. Functionality or aesthetics? A pilot study of music therapy in the treatment of multiple sclerosis patients. Complement Ther Med. 2005;13:25-33.
Ostermann T, Schmid W. Music therapy in the treatment of multiple sclerosis: a comprehensive literature review. Expert Rev Neurother. 2006;6(4): 469-477.
Moreira SV, França CC, Moreira MA, Lana-Peixoto MA. Musical identity of patients with multiple sclerosis. Arq Neuropsiquiatr. 2009;67(1):46-49.
Kelly NA. The use of visual art for stress relief: a case report of newly diagnosed multiple sclerosis. Explore. (NY) 2009;5(3):167-170. https://doi.org/10.1016/j.explore.2009.02.001
Dennison L, Moss-Morris R, Yardley L, Kirby S, Chalder T. Change and processes of change within interventions to promote adjustment to multiple sclerosis: learning from patient experiences. Psychol Health. 2013;28(9):973-992. https://doi.org/10.1080/08870446.2013.767904
Alekseenko EV, Sysoeva OS, Smagina IV, Fedyanin SA. Izmeneniya psikhologicheskogo statusa u bol’nykh rasseyannym sklerozom. Byulleten’ sibirskoi meditsiny. 2008;5:11-13. (In Russ.)
Beckerman H, Blikman LJ, Heine M, Malekzadeh A, Teunissen CE, Bussmann JB, Kwakkel G, van Meeteren J, de Groot V; TREFAMS-ACE study group. The effectiveness of aerobic training, cognitive behavioural therapy, and energy conservation management in treating MS-related fatigue: the design of the TREFAMS-ACE programme. Trials. 2013;14:250. https://doi.org/10.1186/1745-6215-14-250
Bakhteeva TD, Maruta NA. Depressivnye rasstroistva pri rasseyannom skleroze (klinika, diagnostika, terapiya). Ukraїns’kii vіsnik psikhonevrologії. 2011;19(4):36-41. (In Russ.)
Batysheva TT, Kostenko EV, Zaitsev KA, Boiko AN. Opyt organizatsii raboty kabinetov klinicheskoi neiropsikhologii v okruzhnykh nevrologicheskikh otdeleniyakh ambulatornoi nevrologicheskoi sluzhby Moskvy. Zhurn nevrol i psikhiatr im. S.S. Korsakova. 2009;109(2):55-58. (In Russ.)
Salgado BC, Jones M, Ilgun S, McCord G, Loper-Powers M, van Houten P. Effects of a 4-month Ananda Yoga program on physical and mental health outcomes for persons with multiple sclerosis. Int J Yoga Therap. 2013;23:27-38.
Doulatabad SN, Nooreyan K, Doulatabad AN, Noubandegani ZM. The effects of pranayama, hatha and raja yoga on physical pain and the quality of life of women with multiple sclerosis. Afr J Tradit Complement Altern Med. 2012;10(1):49-52.
Patil NJ, Nagaratna R, Garner C, Raghuram NV, Crisan R. Effect of integrated Yoga on neurogenic bladder dysfunction in patients with multiple sclerosis-A prospective observational case series. Complement Ther Med. 2012;20(6):424-430. https://doi.org/10.1016/j.ctim.2012.08.003
Bowling AC. Complementary and alternative medicine in multiple sclerosis. Continuum (Minneap Minn). 2010;16(5 Multiple Sclerosis):78-89. https://doi.org/10.1212/01.CON.0000389935.84660.a5
Crescentini C, Urgesi C, Fabbro F, Eleopra R. Cognitive and brain reserve for mind-body therapeutic approaches in multiple sclerosis: A review. Restor Neurol Neurosc. 2014;32:575-595. https://doi.org/10.3233/RNN-130364
Boehm K, Ostermann T, Milazzo S, Büssing A. Effects of yoga interventions on fatigue: a meta-analysis. Evid Based Complement Alternat Med. 2012;124703.
Mazaheri M, Fanian N, Zargham-Boroujeni A. Experiences of patients with multiple sclerosis from group counseling. Iran J Nurs Midwifery Res. 2011;16(2)181-190.
Mishra SK, Singh P, Bunch SJ, Zhang R. The therapeutic value of yoga in neurological disorders. Ann Indian Acad Neurol. 2012;15:247-254. https://doi.org/10.4103/0972-2327.104328
Firth N. Effectiveness of psychologically focused group interventions for multiple sclerosis: A review of the experimental literature. J Health Psychol. 2014;19:789-801. https://doi.org/10.1177/1359105313479630
Lengdobler H, Kiessling WR. [Group music therapy in multiple sclerosis: initial report of experience]. [Article in German]. Psychother Psychosom Med Psychol. 1989;39(9-10):369-373.
Beckner V, Howard I, Vella L, Mohr DC. Telephone-administered psychotherapy for depression in MS patients: moderating role of social support. J Behav Med. 2010;33:47-59. https://doi.org/10.1007/s10865-009-9235-2
Mohr DC, Likosky W, Bertagnolli A, Goodkin DE, Van Der Wende J, Dwyer P, Dick LP. Telephone-administered cognitive-behavioral therapy for the treatment of depressive symptoms in multiple sclerosis. J Consult Clin Psychol. 2000;68(2):356-361.
Cosio D, Jin L, Siddique J, Mohr DC. The effect of telephone-administered cognitive-behavioral therapy on quality of life among patients with multiple sclerosis. Ann Behav Med. 2011;41(2):227-234. https://doi.org/10.1007/s12160-010-9236-y
Stuifbergen AK, Becker H, Perez F, Morison J, Kullberg V, Todd A. A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis. Clin Rehabil. 2012;26(10):882-893. https://doi.org/10.1177/0269215511434997
Boeschoten RE, Dekker J, Uitdehaag BM, Polman CH, Collette EH, Cuijpers P, Beekman AT, van Oppen P. Internet-based self-help treatment for depression in multiple sclerosis: study protocol of a randomized controlled trial. BMC Psychiatry. 2012;12:137. https://doi.org/10.1186/1471-244X-12-137
Hind D, Cotter J, Thake A, Bradburn M, Cooper C, Isaac C, House A. Cognitive behavioral therapy for the treatment of depression in people with multiple sclerosis: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:5. https://doi.org/10.1186/1471-244X-14-5
Rosti-Otajärvi E, Mäntynen A, Koivisto K, Huhtala H, Hämäläinen P. Predictors and impact of the working alliance in the neuropsychological rehabilitation of patients with multiple sclerosis. J Neurol Sci. 2014;338(1-2):156-161. https://doi.org/10.1016/j.jns.2013.12.039
Iranmanesh S, Tirgari B, Tofighi M, Forouzi MA. Spiritual wellbeing and perceived uncertainty in patients with multiple sclerosis in south-east Iran. Int J Palliat Nurs. 2014;20(10):483-492. https://doi.org/10.12968/ijpn.2014.20.10.483
Pantyuk IV, Buko NS, Venglinskaya TV. Biologicheskie i psikhologicheskie faktory, vliyayushchie na reabilitatsionnyi potentsial bol’nykh rasseyannym sklerozom. Aktual’nye problemy nevrologii i neirokhirurgii. Minsk. 2008;10:185-195. (In Russ.)
Zakharov AV, Kuznetsova NI, Khivintseva EV, Vlasov YaV. Osobennosti reabilitatsii pri rasseyannom skleroze. Nevrologicheskii vestnik. 2010;42:1-2:110-114. (In Russ.)
Khan F, Turner-Stokes L, Ng L, Kilpatrick T. Multidisciplinary rehabilitation for adults with multiple sclerosis. Cochrane Database Syst Rev. 2007;2:CD006036.
Stathopoulou A, Christopoulos P, Soubasi E, Gourzis P. Personality characteristics and disorders in multiple sclerosis patients: assessment and treatment. Int Rev Psychiatry. 2010;22(1):43-54. https://doi.org/10.3109/09540261003589349
Sørensen J, Lee A, Løvendahl B, Nørgaard M, Bay J, Rasmussen PV, Boesen F. Study protocol: to investigate effects of highly specialized rehabilitation for patients with multiple sclerosis. A randomized controlled trial of a personalized, multidisciplinary intervention. BMC Health Serv Res. 2012;12:306. https://doi.org/10.1186/1472-6963-12-306
Asano M, Raszewski R, Finlayson M. Rehabilitation interventions for the management of multiple sclerosis relapse: a short scoping review. Int J MS Care. 2014;16(2):99-104. https://doi.org/10.7224/1537-2073.2013-031
Donzé C. Neurorehabilitation in multiple sclerosis: an overview [Article in French]. Rev Neurol (Paris). 2007;163(6-7):711-719.