Predictors of clinical response to an internet-delivered cognitive behavioural based intervention for symptoms of depression, anxiety and disability in people with multiple sclerosis

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-08-22 DOI:10.1016/j.jpsychores.2025.112367

Milena Gandy, Wendy Wu, Blake F. Dear

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引用次数: 0

Abstract

Introduction

This study sought to identify demographic, clinical, or psychological factors associated with response to an internet-delivered psychological intervention for depression, anxiety, and disability among adults with Multiple Sclerosis (MS). Identifying these characteristics can help inform psychotherapy referral decisions.

Method

Data from participants with a diagnosis of MS (n = 222) were pooled across three clinical trials of an established internet-delivered intervention for people with neurological conditions, including MS. Baseline demographic (age, sex, employment, education, relationship status), clinical (MS type, cognitive difficulties, current psychotropic medication use, previous psychological treatment) and psychological characteristics (baseline symptom severity) were examined. Outcomes included a clinically meaningful response (≥25 % improvement in symptoms) in self-reported symptoms of depression, anxiety, and disability following the intervention. Multivariable logistic regression models were built to identify significant predictors of response. Area under the curve and Negelkerke's R² are reported.

Results

No robust or consistent factors were associated with the likelihood of a clinically meaningful response across these primary outcomes. Only a few factors predicted a single outcome: baseline depression symptom severity predicted greater odds of a clinical response in depression, age predicted greater odds of response in anxiety, and MS subtype predicted greater odds of response in disability. Current use of psychotropic medication was the only factor that predicted more than one outcome, specifically depression and disability.

Conclusion

Findings highlight the limited predictive value of baseline characteristics, suggesting that referral to internet-delivered psychological interventions for adults with MS should not rely solely on simple demographic or clinical profiles

查看原文本刊更多论文

对多发性硬化症患者抑郁、焦虑和残疾症状的基于互联网的认知行为干预的临床反应预测因素

本研究旨在确定与网络心理干预对多发性硬化症（MS）成人抑郁、焦虑和残疾的反应相关的人口统计学、临床或心理因素。识别这些特征有助于心理治疗转诊决策。方法将诊断为多发性硬化症的参与者（n = 222）的数据汇集到三个临床试验中，这些试验是针对神经系统疾病患者进行的一项已建立的互联网干预，包括多发性硬化症的基线人口统计学（年龄、性别、就业、教育程度、关系状况）、临床（多发性硬化症类型、认知困难、目前使用精神药物、以前接受过心理治疗）和心理特征（基线症状严重程度）。结果包括干预后自我报告的抑郁、焦虑和残疾症状有临床意义的缓解（症状改善≥25%）。建立多变量逻辑回归模型以确定反应的显著预测因子。报告了曲线下面积和Negelkerke R2。结果：在这些主要结局中，没有强有力的或一致的因素与临床有意义的反应的可能性相关。只有少数因素预测单一的结果：基线抑郁症状的严重程度预测抑郁症患者临床反应的可能性更大，年龄预测焦虑患者反应的可能性更大，MS亚型预测残疾患者反应的可能性更大。目前精神药物的使用是预测不止一种结果的唯一因素，特别是抑郁和残疾。结论：研究结果强调了基线特征的有限预测价值，提示对成年MS患者进行网络心理干预不应仅仅依赖于简单的人口统计学或临床资料

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.