An online programme to reduce depression in patients with multiple sclerosis: a randomised controlled trial

Fischer, Anja; Schröder, Johanna; Vettorazzi, Eik; Wolf, Oliver T; Pöttgen, Jana; Lau, Stephanie; Heesen, Christoph; Moritz, Steffen; Gold, Stefan M

doi:10.1016/s2215-0366(14)00049-2

Cited by 143Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMultiple Sclerosis Research Studies

An online programme to reduce depression in patients with multiple sclerosis: a randomised controlled trial

Fischer, Anja, Schröder, Johanna, Vettorazzi, Eik, Wolf, Oliver T, Pöttgen, Jana, Lau, Stephanie, Heesen, Christoph, Moritz, Steffen +1 more·2015·The Lancet Psychiatry

DOI 10.1016/s2215-0366(14)00049-2

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Abstract

Background With a lifetime risk for major depressive disorder of up to 50%, depression is a common comorbidity in multiple sclerosis but remains widely underdiagnosed and untreated. We investigated the potential of a fully automated, internet-based, cognitive behavioural therapy programme, Deprexis, to reduce depressive symptoms in patients with multiple sclerosis.Methods For this randomised controlled trial, we recruited patients from an outpatient clinic in Hamburg, Germany. Patients aged 18-65 years were eligible for inclusion if they had multiple sclerosis and self-reported depressive symptoms. By use of a computer-generated randomisation sequence, we allocated 90 patients (1:1; no blocking or stratification) to either the intervention group or a waitlist control group for 9 weeks. The primary endpoint was the Beck Depression Inventory (BDI), as assessed by an intention-to-treat analysis. This trial is registered with ClinicalTrials.gov, number NCT01663649.Findings 71 patients completed the trial: 35 patients in the intervention group and 36 patients in the control group. During the intervention, BDI scores decreased in the Deprexis group and increased in the control group, yielding a positive effect of Deprexis relative to the waitlist group (mean group difference -4·02 points [95% CI -7·26 to -0·79], p=0·015, effect size d=0·53). Worsening of depressive symptoms from below to above the clinical cutoff (BDI >13) occurred in three (7%) of 45 patients in the control group and no patients in the Deprexis group. We noted no adverse events with respect to new occurrence of suicidal ideation during the trial.Interpretation Psychological online-intervention programmes could be suitable for patients with multiple sclerosis who are unable to regularly attend therapeutic sessions because of mobility impairments.Funding European Union and the Deutsche Forschungsgemeinschaft.

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Online CBT for depression in MS resulted in lower BDI-II scores at post and 6 months follow-up compared to a waitlist control group.
“The researchers found that those who completed the 9-week online CBT program reported lower BDI-II scores at post and 6 months follow up compared to those in a waitlist control group.”
From A pilot randomized controlled trial of a tailored cognitive behavioural therapy based intervention for depressive symptoms in those newly diagnosed with multiple sclerosis (2016) · cites this paper as [15]
The paper’s findings (p. 1) report lower BDI scores after the 9-week Deprexis programme relative to the waitlist group. The methods (p. 4) mention a six-month follow-up assessment, but the passages do not report lower scores than the waitlist group at that time; they also identify the measure as BDI, not BDI-II. (LLM, conf=0.88)
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Authors: Fischer, A., Schröder, J., Vettorazzi, E., Wolf, O. T., Pöttgen, J., Lau, S., Heesen, C., Moritz, S., & Gold, S. M.
Affiliations: University Medical Center Hamburg-Eppendorf (DE)
Ruhr University Bochum (DE)
Corresponding author: Gold, Stefan M
ORCID: Schröder, Johanna
Vettorazzi, Eik
Wolf, Oliver T
Pöttgen, Jana
Lau, Stephanie
Heesen, Christoph
Moritz, Steffen
Gold, Stefan M
Venue: The Lancet Psychiatry
Publisher: Elsevier BV
Published: 2015-03
Volume: 2
Issue: 3
Pages: 217-223
ISSN: 2215-0366 (ISSN-L)
DOI: 10.1016/s2215-0366(14)00049-2
OpenAlex: W2156610258
Cited by: 143
References: 39
Citations by year: 2026: 7 · 2025: 8 · 2024: 18 · 2023: 17 · 2022: 11 · 2021: 14 · 2020: 17 · 2019: 8 · 2018: 9 · 2017: 12 · 2016: 18 · 2015: 3 · 2014: 1
FWCI: 22.79
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet Psychiatry (publishedVersion)
PubMed (publishedVersion)
CLOK (University of Central Lancashire) (acceptedVersion)
Funders: European Union Seventh Framework Program (FP7/2007-2013)
Heisenberg Fellowship from the Deutsche Forschungsgemeinschaft (DFG, GO1357/4-1 and 5-1)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
Keywords: multiple sclerosis, depression, internet-based cognitive behavioral therapy, online intervention, Deprexis, depressive symptoms, waitlist control, Beck Depression Inventory, comorbidities, mobility impairment
MeSH terms: Adolescent, Adult, Aged, Depression, Female, Germany, Humans, Male, Middle Aged, Multiple Sclerosis, Psychiatric Status Rating Scales, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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An online programme to reduce depression in patients with multiple sclerosis: a randomised controlled trial

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