University of Alabama at Birmingham, Department of Physical Therapy, Birmingham, AL, United States.
University of Alabama at Birmingham, Department of Physical Therapy, Birmingham, AL, United States.
Mult Scler Relat Disord. 2021 Jun;51:102904. doi: 10.1016/j.msard.2021.102904. Epub 2021 Mar 18.
Major depression disorder (MDD) and severe depression symptoms are highly prevalent in multiple sclerosis (MS). Depression can worsen symptoms of MS and is associated with significantly reduced quality of life and increased risk of suicide. Currently, there is no gold-standard, single treatment available for depression in MS. Pharmacotherapy, cognitive behavior therapy (CBT), and exercise training individually are moderately, yet incompletely, efficacious for managing depression in the general population and MS.
This review provides an overview of evidence from meta-analyses and systematic reviews for current treatments of depression in persons with MS. This review further develops the rationale for using a combinatory treatment approach in persons with MS.
We performed a narrative review of meta-analyses and systematic reviews regarding the current state of evidence for the three most common treatments of depression in persons with MS (i.e., antidepressant medication, cognitive-behavior therapy, and exercise training). We provide a concise assessment of the overall effect of these treatments on depression in the general population and then persons with MS. We further note short-comings of research on these treatments for depression.
There is no single, gold-standard treatment for depression in MS, and we proposed that combinatory treatments should be considered for the management of depression in MS. However, there is a paucity of evidence for the use of combinatory therapy on depression and its outcomes in persons with MS, and this supports direct examination of the feasibility and efficacy of such combinatory approaches for MDD in MS.
多发性硬化症（MS）患者中普遍存在重度抑郁症（MDD）和严重抑郁症状。抑郁会使 MS 症状恶化，并与生活质量显著降低以及自杀风险增加相关。目前，针对 MS 患者的抑郁症尚无单一的金标准治疗方法。在普通人群中，药物治疗、认知行为疗法（CBT）和运动训练单独使用对治疗抑郁症有一定疗效，但疗效并不完全。
本文对多发性硬化症患者抑郁症治疗的荟萃分析和系统评价证据进行综述，进一步为 MS 患者采用联合治疗方法提供理论依据。
我们对关于 MS 患者三种最常见抑郁症治疗方法（即抗抑郁药、认知行为疗法和运动训练）的荟萃分析和系统评价进行了叙述性综述。我们简要评估了这些治疗方法对普通人群和 MS 患者抑郁症的总体疗效。此外，我们还指出了这些治疗方法在抑郁症研究方面的不足之处。
MS 患者没有单一的金标准治疗方法，我们建议联合治疗应考虑用于 MS 患者的抑郁症管理。然而，针对 MS 患者的联合治疗对抑郁症及其结果的研究证据不足，这支持对这种联合方法治疗 MS 重度抑郁症的可行性和疗效进行直接评估。
