Cognitive behavioural therapy software for the treatment of depression in people with multiple sclerosis

INTERVENTION: Participants are randomly allocated to one of two groups. Intervention group: CBT software (Ultrasis ‐ Beating the Blues®) Control group: Treatment as usual Ultrasis ‐ Beating the Blues® is a computer‐interactive programme for the treatment of anxiety and depression. It is based on cognitive behavioural therapy (CBT), which helps patients to identify and change unhelpful ways of thinking and to learn more effective ways of solving problems. The programme consists of two interwoven strands: the cognitive (or "thinking") strategies and the behavioural (or "doing") strategies. Patients are helped to understand the causes and symptoms of anxiety and depression and to work on their specific problems. The programme consists of a 15 minute "Introduction to Therapy" video plus eight computer‐interactive sessions of approximately 50 minutes each in duration. Each session consists of a mix of cognitive and behavioural strategies, which are customised to the patient's individual problems. The eight computer sessions are designed to be taken weekly, or thereabouts, and each session builds on the previous one. Patients can repeat sessions if they wish. The computer keeps track of which session they have reached. Total duration of interventions: 8 weeks Total duration of follow‐up: 3 months CONDITION: 1. Multiple sclerosis (MS) 2. Depression ; Mental and Behavioural Disorders ; Depressive episodes in MS sufferers PRIMARY OUTCOME: Change in self‐reported symptoms of depression: the difference between mean change scores of CCBT and standard care, as measured on the Beck Depression Inventory ‐ Second Edition (BDI‐II) 21‐item self report instrument. Recorded at baseline, eight weeks or on completion of CCBT (whichever is later) and three months thereafter. SECONDARY OUTCOME: The following will be recorded at baseline, eight weeks or on completion of CCBT (whichever is later) and three months thereafter: ; 1. Depression as measured on the Patient Health Questionnaire‐9 item (PHQ‐9); 2. Anxiety measured on the Generalised Anxiety Disorder‐7 item (GAD‐7); 3. Disease‐specific quality of life, measured on the Multiple Sclerosis Impact Scale‐29 item (MSIS‐29); 4. Generic health‐related quality of life, measured on the 36‐item Short Form health survey (SF‐36) INCLUSION CRITERIA: 1. Aged 18+, both males and females 2. Diagnosis of MS confirmed by neurologist 3. Beck Depression Inventory‐II score of at least 14 on two consecutive occasions 4. Not currently or within past three months receiving any treatment from a psychologist, psychotherapist or psychiatrist 5. Willingness to be randomised to CCBT, at home or primary care facility or treatment as usual