Table 4.
Characteristics of the included articles
| Authors, publication year |
Programme name | Study design | Quality of life measurement | Sample size (N) Age (median) Sex (female%) |
Main results |
| Mindfulness-based therapies | |||||
| Carletto et al (2017)106 | Body-affective mindfulness (BAM) | Longitudinal (T1=basal level/T2=post-treatment/T3=6 months later) | Functional Assessment of Multiple Sclerosis (FAMS) | N=45 44.1 years 71.1% |
Increase in general score FAMS from T1 to T2 (p<0.001) and from T2 to T3 (p=1). |
| Besharat et al (2017)107 | Mindfulness-based stress reduction (MBSR) | Longitudinal (T1=pre-treatment/T2=post-treatment) | Short Form Health Survey 36 (SF-36) | N intervention/control=12/11 35 years 100% |
Increase in general QoL score in the intervention group (p<0.05). |
| Blankespoor et al (2017)108 | Mindfulness-based Stress Reduction (MBSR) | Longitudinal (T1=pre-treatment/T2=post-treatment) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N=25 52.6 years 84% |
Increase PCS (p<0.001). |
| Simpson et al (2017)109 | Mindfulness-based Stress Reduction (MBSR) | Longitudinal (T1=pre-treatment/T2=post-treatment/T3=3 months later) | Multiple Sclerosis Quality of Life Inventory (MSQLI) | N=25 43.6 years 92% |
Small and insignificant increase QoL from T1 to T2 (p=0.48) and insignificant increase from T2 to T3 (p=0.71). |
| Spitzer et al (2018)110 | Community-based group mindfulness | Longitudinal (T1=pre-treatment/T2=post-treatment/T3=8 weeks later) | Short Form Health Survey 36 (SF-36) | N=23 48.4 years 91.3% |
Increase MCS from T1 to T2 (p=0.008). |
| Ghodspour et al (2018)111 | Mindfulness-based Cognitive Therapy (MBCT) | Longitudinal (T1=pre-treatment/T2=post-treatment) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N intervention/control=15/15 36 years 100% |
Increase in health distress (p=0.032), mental well-being (p=0.001), role limitation due to emotional problems (p=0.005) and cognitive performance (p=0.04) subscales. |
| Cognitive behavioural | |||||
| Case et al (2018)112 | Trial of healing light guided imagery (HLGI) | Longitudinal (T1=pre-treatment/T2=post-treatment) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N intervention/control=9/8 49.1 years – |
Increase in PCS (p=0.01) and MCS (p<0.01) in the intervention group. |
| Blair et al (2017)113 | Dialectical Behaviour Group Therapy (TCD) | Longitudinal (T1=pre-treatment/T2=post-treatment/T3=6 months later) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N intervention/control=10/10 40.4 years 90% |
Increase in MSQoL-54 from T1 to T3 (p=0.01). |
| Calandri et al (2017)114 | Group-based cognitive behavioural therapy (CBT) | Longitudinal (T1=pre-treatment/T2=6 month post-treatment/T3=1 year post-treatment) | Short Form Health Survey 12 (SF-12) | N intervention/control=54/31 38 years 61% |
Increase in MCS T2 in the CBT group vs control (p=0.036). Increase in MCS T3 in the CBT group vs control (p=0.049). |
| Graziano et al (2014)115 | Group-based cognitive behavioural therapy (CBT) | Longitudinal (T1=pre-treatment/T2=post-treatment/T3=6 months later) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N intervention/control=41/41 42.3 years 66% |
Increase in MSQoL-54 at T3 in the CBT group vs control group (p<0.05). |
| Kiropoulos et al (2016)116 | Cognitive behavioural therapy (CBT) for depressive symptoms | Longitudinal (T1=pre-treatment/T2=post-treatment/T3=20 weeks later) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N intervention/control=15/15 34.6 years 86.7% |
Differences between control and CBT group MCS and PCS in T2 and T3 (p<0.001). |
| Chruzander et al (2016)117 | Cognitive behavioural therapy (CBT) focused on depressive symptoms | Longitudinal (T1=basal level/T2=3 weeks post-treatment/T3=3 months post-treatment) | Multiple Sclerosis Impact Scale (MSIS-29) EuroQol 5-Dimensions (EQ-5D) EuroQol Visual Analogue Scale (EQ-VAS) |
N=15 38 years 80% |
Improvement in QoL from MSIS-29 and EQ-5D in T2 and T3 (p<0.05). |
| Kikuchi et al (2019)118 | Cognitive behavioural therapy (CBT) on depression | Longitudinal (T1=pre-treatment/T2=mind-treatment/T3=post-treatment) | Functional Assessment of Multiple Sclerosis (FAMS) | N=7 46.1 years 71.4% |
Positive but not significant increase in FAMS (p>0.05). |
| Pakenham et al (2018)119 | Resilience Training Programme (ACT) | Longitudinal (T1=pre-treatment/T2=post-treatment/T3=3 months later) | Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54) | N=37 39.4 years 73% |
Increase in PCS (p<0.001) and MCS (p<0.006) from T1 to T2, maintained at T3, without significant changes. |
| Proctor et al (2018)120 | Telephone-supported acceptance and commitment bibliotherapy (ACT) | Longitudinal (T1=pre-randomisation/T2=12 weeks after randomisation) | EuroQol 5-Dimensions (EQ-5D) | N intervention/control=14/13 45.8 years 78% |
No significant increase in QoL (p=0.62). |
| Social and group support | |||||
| Liu (2017)125 | Hope-Based Group Therapy (HBGT) | Longitudinal (T1=pre-treatment/T2=post-treatment) | Multiple Sclerosis Impact Scale (MSIS-29) | N intervention/control=18/14 35.1 years 100% |
Physical and psychological QoL increase in HBT group (p<0.05). |
| Abolghasemi et al (2016)121 | Supportive–Expressive Therapy (SE) | Longitudinal (T1=pre-treatment/T2=post-treatment | WHO Quality of Life questionnaire (WHOQoL-BREF) | N intervention/control=16/16 31.8 years 41.7% |
Increase QoL from T1 to T2 (p<0.001). |
| Jongen et al (2016)123 | Intensive social cognitive treatment (can do treatment) with participation of support partners | Longitudinal (T1=basal level/T2=12 months post-treatment) | Multiple Sclerosis Quality of Life Instrument (MSQoL-54) | N=38 – 65.8% |
PCS increase (p=0.032) and MCS (p=0.087) in the RR group. |
| Jongen et al (2014)122 | Intensive social cognitive wellness programme with participation of support partners | Longitudinal (T1=basal level/T2=1 months post-treatment/T3=3 months post-treatment T4=6 months post-treatment | Multiple Sclerosis Quality of Life Instrument (MSQoL-54) | N=44 45.7 years 79.5% |
MCS increase at T2, T3 and T4 and PCS at T4 (p<0.05). |
| Eliášová et al (2015)124 | Self-Help group (SH) | Cross-sectional (T1=after the treatment) | WHO Quality of Life questionnaire (WHOQoL-BREF) | N intervention/control=46/35 42.2 years 59% |
Increase in physical (p<0.001), psychological (p<0.001) and social relationships (p<0.001) in the SH group. |
| Symptom and self-management-based therapies | |||||
| Mulligan et al (2016)126 | Fatigue self-management programme ‘Minimise Fatigue, Maximise Life: Creating Balance with Multiple Sclerosis (MFML)’ | Longitudinal (T1=1 month pre-treatment/T2=pre-treatment/T3=post-treatment). | Short Form Health Survey 12 (SF-12) | N=24 49.3 years 100% |
Positive but not significant changes in SF-12 (p>0.05). |
| Thomas et al (2014)127 | Group-based fatigue management (FACETS) | Longitudinal (T1=1 week before treatment/T2=1 month post-treatment/T3=4 month post-treatment/T4=12 month post-treatment) | Multiple Sclerosis Impact Scale (MSIS-29) Short Form Health Survey 36 (SF-36) |
N intervention/control=84/80 48 years 73% |
Changes in physical health MSIS-29 (p=0.046) and vitality SF-36 (p=0.03) at T4. |
| Ehde et al (2015)128 | Telephone-Delivered Self-Management (SM) | Longitudinal (T1=before group randomisation/T2=post-treatment/T3=6 month post-treatment/T4=12 month post-treatment) | Short Form Health Survey 8 (SF-8) | N intervention/control=75/88 51 years 89.3% |
MCS and PCS increase at T2, T3 and T4 (p<0.05). |
| Feicke et al (2014)129 | Education programme for self-management competencies (S.MS) | Longitudinal (T1=1 basal level/T2=post-treatment/T3=6 month post-treatment) | Hamburg quality of life questionnaire in multiple sclerosis (Sclerosis Quality) | N intervention/control=31/33 41.9 years 87.1% |
Stable positive changes in QoL (p=0.007). |
| Other psychological intervention | |||||
| LeClaire et al (2018)130 | Group Positive Psychology | Longitudinal (T1=basal level/T2=post-treatment) | Short Form Health Survey 36 (SF-36) | N=11 53.5 years 100% |
Increase in SF-36 vitality subscale score (p=0.016). Increase in mental health SF-36 subscale (p=0.098) that did not reach statistical significance. |
HBT, hope-based group therapy; MCS, mental component score; PCS, physical component score; QoL, quality of life; RR, relapsing–remitting.