Psychotherapeutic care for patients with multiple sclerosis

The diagnosis of multiple sclerosis (MS) leads to traumatic experiences and depression in a number of patients. Doctors are faced with the need to treat not only a neurological disease, but also its concomitant pathology in the form of anxiety, depression and adjustment disorders. The search for the necessary therapy led to a combined treatment program that includes psychopharmacotherapy and psychotherapy. The purpose of this study is to study the effectiveness of the proposed psychotherapy program, to assess the impact of these changes on the patient’s quality of life. Patients and methods 203 patients with a clinically confirmed diagnosis of MS participated. Taking into account the course of the disease, MS patients were divided into 88.2 % (179 people) with a remitting (RRS) type of MS and 11.8 % (24 people) with a secondary progressive course (RRS). The disability index varied in patients with RRS 2.89±0.16 points, and in patients with RRS (5.0±0.24) points. To confirm the severity of depression, the A. T. Beck depression scale and the self-assessment scale of depression, attitude to the disease (using the TOBOL method, the type of attitude to the disease, the quality of life Questionnaire MSQoL-54) were used. Results and discussion, taking into account the presence of depressive symptoms, patients with multiple sclerosis are represented by two groups: Group No. 1 of MS without depression — 90 people and Group No. 2 of MS with depression — 113 people. Depending on the therapy, Group No. 1 of MS without depression included patients from subgroup No. 1.1–36 people who did not require psychotherapeutic correction and subgroup No. 1.2–54 people who participated in psychotherapeutic correction. Group No. 2 included patients with MS and depression, where subgroup No. 2.1 included 44 patients who received only psychopharmacological treatment with antidepressants, and subgroup No. 2.2 included 69 patients with remitting MS who received both antidepressants and psychotherapeutic intervention. The results of this therapeutic work clearly demonstrate changes in the typology of attitudes towards the disease in patients with multiple sclerosis. After the treatment program, MS patients noticeably p<0.001 decrease in symptoms of anxiety, apathy, mood background stabilizes and adequately assess their condition, actively participate in the treatment of the disease, which indicates a high rehabilitation potential of MS patients with depression and the ability of MS patients to cope with the disease, which is confirmed by quality of life indicators in the form of p<0.001 expanding physical and emotional roles, reducing pain, increasing emotional well-being, improving well-being, expanding social connections, improving the overall quality of life and overall physical and mental health. Conclusion. The use of combined therapeutic intervention helps MS patients more successfully overcome the negative emotional effects of stress and affective disorders, increases motor activity and adaptive capabilities, thereby increasing the rehabilitation potential and quality of life of MS patients.