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The effectiveness of emotional wellness programs on mental health outcomes for adults with multiple sclerosis: a systematic review and meta-analysis
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posted on 2023-04-19, 00:09 authored by RD Russell, LJ Black, NM Pham, A BegleyBackground: People with multiple sclerosis (MS) have a greater prevalence of depression and anxiety than the general population. Emotional wellness programs (any psychological or psychosocial interventions that focus on awareness, acceptance, managing, or challenging thoughts and feelings) could be important for people with MS. However, there have been no reviews on the effectiveness of emotional wellness programs for people with MS. The objective of this review was to determine the effectiveness of emotional wellness programs on mental health outcomes for adults with MS. Inclusion criteria: Randomised controlled trials (RCTs) and quasi-experimental trials evaluating emotional wellness programs for adults with any form of MS were included. Mental health outcomes included were depression, anxiety, quality of life, and stress. The comparator groups were waitlist controls, usual care, or another intervention. Methods: This review was registered with PROSPERO (registration number CRD42019131082) and conducted in accordance with PRISMA guidelines. CINAHL, Cochrane, MEDLINE, PsycInfo, Web of Science, ProQuest Dissertations and Theses, Cochrane register of Controlled Trials, and Google Scholar were searched for English- language publications. Titles and abstracts were initially screened, followed by a screen of full text articles. Studies were critically appraised for methodological quality using the JBI standardised critical appraisal checklists. Data were extracted on intervention details, study outcome measures, behaviour change techniques, and results. Random effects meta-analyses were performed for outcomes assessed in at least five studies, with results reported as the standardised mean difference (SMD). Results: This review comprised 25 RCTs and four quasi-experimental studies (n participants=2323); 21 were included in meta-analyses. Meta-analyses produced statistically significant results favouring the interventions (SMD (95% CI) for depression -0.55 (-0.87, -0.24); anxiety -0.42 (-0.70, -0.14); quality of life 0.28 (0.14, 0.43); and stress -1.00 (-1.58, -0.43)). The most commonly used behaviour change techniques were behaviour practice/rehearsal, social comparison, and social support. Conclusions: This review provides evidence to support the effectiveness of emotional wellness programs for improving mental health outcomes in adults with MS. However, these findings should be interpreted with caution given the high degree of heterogeneity between the studies, and potential for biases in analysis due to missing data and/or incomplete reporting.
History
Journal
Multiple Sclerosis and Related DisordersVolume
44Article number
102171Pagination
102171-102171Location
NetherlandsPublisher DOI
ISSN
2211-0348eISSN
2211-0356Language
enPublisher
Elsevier BVUsage metrics
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Keywords
Anxietybehavior change techniquesdepressionemotional wellnessquality of lifestressAdultHealth PromotionHumansMental HealthMultiple SclerosisOutcome Assessment, Health CareanxietyMind and BodyClinical Trials and Supportive ActivitiesNeurodegenerativeDepressionClinical ResearchBehavioral and Social ScienceBrain DisordersNeurosciences6.6 Psychological and behavioural6 Evaluation of treatments and therapeutic interventionsMental health3 Good Health and Well BeingNeurosciences not elsewhere classified
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