• Logo
  • SBMUJournals

The Effectiveness of Quality of Life Therapy on Depression and Anxiety among Patients with Multiple Sclerosis

Leila Hashemi, Changiz Rahimi, Nurollah Mohammadi




Introduction: Many patients with incurable disease, like multiple sclerosis (MS), experience depression and anxiety, therefore, this study aimed at investigating the effectiveness of quality of life therapy (QOLT) among patients with multiple sclerosis (MS), depression and anxiety.  Methods: The design of the study was semi-experimental with an experimental group and a control group, including three phases; a pre-test, a post-test and a follow-up test. Statistical population consisted of patients suffering from MS referring to health centers in Shiraz, Iran. 24 patients were selected using convenience-sampling method. They were randomly assigned to the experimental and control groups (each 12 members). The experimental group received QOLT during eight 50minute weekly sessions. The control group received no treatment. All participants completed the Beck Depression Inventory–II and Beck Anxiety Inventory. The data were analyzed using the analysis of covariance method.  Results: Comparison of the means of depression and anxiety scores of two groups in post-test phase showed that quality of life therapies had significant effects on reduction of depression (p<0.001) and anxiety (p<0.001) rates in MS patients. Comparing two groups in a follow-up phase showed that the effect of intervention was stable.  Conclusion: This research showed that quality of life therapy has decreased depression and anxiety rate significantly in MS patients. It seems that using psychological intervention can improve the well-being of MS patients and they can benefit from the positive effects of a quality time program. Therefore, it is recommended that, in addition to prescription of medications, psychological interventions be done for these patients. Declaration of Interest: None


Multiple Sclerosis, Quality of life therapy, Depression, Anxiety


Fauci A, Brauwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al. Harrison's Principles of Internal Medicine, 19th ed. New York: McGraw-Hill Education; 2015.

Kenner M, Menon U, Elliott DG. Multiple sclerosis as a painful disease. Int Rev Neurobi 2007; 79, 303-321.

National Multiple Sclerosis Society. Multiple sclerosis: Just the facts, general information (No. ER6007). Charlotte, NC: National MS Society; 2011.

WHO. Mental health, Neurological Disorders: Public Health Challenges. 2011; Available from: http://www.who.int/mental_health/neurology/at las-ms-webpdf.

Dua T, Rompani P. Atlas: Multiple sclerosis resources in the world. 1 ed .Geneva: World Health Organization; 2008.

Currie R. Spasticity: a common symptom of multiple sclerosis. J Nurs Stand 2001; 15(33), 47-52.

Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. J Mult Scler 2007; 13, 67-72.

Boeschoten RE, Annemaria MJ., Aartjan TF, Uitdehaag MJ, et all. Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis. J Neurol Sci 2017; 331-341.

Chwastiak LA, Ehde DM. Psychiatric Issues in Multiple Sclerosis. Psychiatric Clin North Am 2007; 30(4),803-17.

Feinstein, A. An examination of suicidal intent in patients with multiple sclerosis. Neurology 2002; 59, 674–678.

Mohr DC, Hart SL, Fonareva I, Tasch ES. Treatment of depression for patients with multiple sclerosis in neurology clinics. Mult Scler J 2006; 12 (2), 204–208.

Liu XJ, Ye HX, Li WP, Dai R, Chen D, Jin M. Relationship between Psychosocial Factors and Onset of Multiple Sclerosis. Eur J Neurol 2009; 62(3), 130-6.

Frisch MB. Quality of life therapy. New Jersey:Wiley press; 2006.

Askey JS, David A, Silber E, Shaw P, Chalder T. Cognitive behaviour therapy for common mental disorders in people with Multiple Sclerosis: A bench marking study. Behav Res Ther 2013; 51, 648–55.

Fiest KM, Walker JR, Bernstein CN, Graff LA, Zarychnski R, Abousetta SB, et al. Systematic review and meta-analysis of interventions for depression and anxiety in persons with multiple sclerosis. Mult Scler Relat Disord 2016; 12-26.

Fernie BA, kollmann J, Brown RG. Cognitive behavioural interventions for depression in chronic neurological conditions: A systematic review. J. Psychosom. Res 2015; 411-419.

Hind D, Cotter J, Thake A, Bradburn M, Cooper C, Isaac C, House A. Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: a systematic review and meta-analysis. BMC Psychiatry 2014; 5, 9-14.

Beckner V, Howard I, Vella L, Mohr D. Telephone-administered psychotherapy for depression in MS patients: moderating role of social support. J Behav Med 2010; 33 (1), 4759.

Thomas PW, Thomas S, Hillier C, Galvin K, Baker R. Psychological interventions for multiplesclerosis. Cochran Database Syst Rev 2006; (1), CD004431.

Jose Sa M . Psychological aspects of multiple sclerosis. Clin Neurol Neurosurg 2008; 110 : 868-877.

Asadnia A, Mosarrezaii Aghdam A, Saadatmand S, Sepehrian Azar F, Torabzadeh N. Examining the effectiveness of cognitive behavior therapy on improving depression and decreasing anxiety symptoms of multiple sclerosis patients. Urumia Med J 2014; 25(11),1023-1032.(persian)

Shariati ME, Toghyani M. Evaluation of Quality of Life Therapy (QOLT) for Parents of Middle School Male Students with Behavioral Problems. Journalsih 2015; 3(5), 2345-2633.

Padash Z, Fathehizade M, Abedi M, Izadikha Z. The effect of quality of life therapy on marital satisfaction. J Res Behaves Sci 2010; 10(5): 363-72.

Toghyani M, Kalantari M, Amiri S, Molavi H. The effectiveness of quality of life therapy on subjective well-being of male adolescents. Soc Behav Sci 2011; (30), 1752 – 1757.

Padash Z, Fathehizade M, Abedi M, Izadikha Z. The effect of quality of life therapy on happiness in wives in Esfahan. Journal of Family Counseling & Psycholotherapy 2011; 1, 130-115. (Persian).

Abedi MR, Vostanis P. Evaluation of quality of life therapy for parents of children with obsessive-compulsive disorders in Iran. Eur Child Adolesc Psychiatry 2010; 19, 605-613.

Rodrigue JR, Maher AB, Widows MR, Ehler SL. A randomized evaluation of quality of life therapy with patients awaiting lung transplantation. Am J Transplant 2005; 5, 24252432.

Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corporation;1996.

Ghassemzadeh H, Mojtabai R., Karamghadir IN, Ebrahimkhani N. Psychometric Properties of a Persian-Language Version of the Beck Depression Inventory Second Edition: BDI-IIPersian. Depression and Anxiety 2005; 5(21), 185–192.

Hollon SD, Kendall PC. Cognitive selfstatements in depression: Development of an automatic thoughts questionnaire. Cognit Ther Res 1980; 4 (4), 383-395.

Stefan-Dabson K, Mohammadkhani P, Massah-Choulabi O. Psychometrics Characteristic of Beck Depression Inventory-II in Patients with Magor Depressive Disorder. Jrehab 2007; 8 :82-0

Rahimi C. Application of the Beck Depression Inventory-II in Iranian University Students. CPAP 2014; 2 (10) :173-188.

Beck AT, Epstein N, Brown G. and Steer, R.A. An inventiroy for measuring clinical anxiety: Psychometric properties. J. Consult. Clin. Psychol 1983; 56, 893-897.

Kaviani H, Ahmadi Abhari A. Prevalence of Anxiety Disorders in Tehran City. IJPCP 2003; 8 (3) :4-11.

Nasiri H, Jokar B. The Relationship between Life's Meaningfulness, Hope, Happiness, Life Satisfaction and Depression. JWR 2011; 6(2),157-176.

Hughes, M. Affect, meaning and quality of life. Soc Forces 2006; 85 (2), 611-630.

Ghasemi N, Kajbaf MB, Rabiei M. The Effectivness of Quality of Life Therapy on Subjective Well-Being and Mental Health. Journal Of Clinical Psychology 2011; 3(2),2334. (Persian)

Ehde DM, Bombardier CH. Affective mediator of a physical activity intervention for depression in multiple sclerosis. Rehabi Psychol 2014; 59 (1), 57-56. 39. Garfield AC, Lincoln NB. Factors affecting anxiety in Multiple Sclerosis. Disabil Rehabil 2012; 34, 2047–2052.

DOI: https://doi.org/10.22037/ijabs.v5i4.22242


  • There are currently no refbacks.