Self Help for Fatigue in Multiple Sclerosis

A Randomised Controlled Trial of Cognitive Behavioural Therapy Based Self Help for Fatigue in Multiple Sclerosis

The purpose of this study is to determine if cognitive behavioural therapy (CBT) based self help is effective for the management of symptoms of fatigue in Multiple Sclerosis (MS).

Background: Fatigue is a common disabling symptom in patients with Multiple Sclerosis (MS). Cognitive behavioural therapy (CBT) has been shown to be effective in the reduction of fatigue in MS and CBT-based self-help has been shown to be effective as a low intensity intervention for anxiety and depression.

Objectives: To evaluate the effectiveness of a CBT based self-help workbook at reducing perceived impact of fatigue in a clinical sample of MS patients.

Inclusion Criteria:

• All participants will be aged 18 or over
• Will have a recognised diagnosis of relapsing remitting or primary progressive relapsing remitting Multiple Sclerosis from a neurologist
• Cognitively able to give informed consent as deemed by referring clinician in the Fife Rehabilitation Service
• Willing to consent to randomised control trial
• Fatigue as a primary symptom

Exclusion Criteria:

• Patients with severe anxiety or depression (assessed by cut off on HADS)
• Patients with psychosis or personality disorders (assessed by referring clinician)
• Patients currently receiving input from psychological services for fatigue management
• Patients with suicidal ideation or plans (assessed by referring clinician)
• Patients who are unable to read the workbook or standardised questionnaires due to literacy levels or cognitive abilities will be excluded from the analysis, although if patients have literacy or cognitive problems, referral to a more suitable 1-to-1 type of therapy will be made.