A Systematic Review of Stress-management Interventions for Multiple Sclerosis Patients

Background: The objective of this study was to identify stress-management interventions used for people with multiple sclerosis (MS) and systematically evaluate the efficacy of these interventions.

Methods: Several strategies were used to search for studies reported in articles published up to 2013.

Results: Our initial search retrieved 117 publications, of which 8 met our criteria for review. Of the eight studies, one provided Class I evidence, five provided Class III evidence, and two provided Class IV evidence for the efficacy of stress-management interventions according to the evidence classification established by the American Academy of Neurology. Most studies showed positive changes in outcomes assessed; however, the range of methodological quality among the published studies made it difficult to draw conclusions.

Conclusions: The promising findings for stress-management interventions highlight the need for future studies. Additional large, prospective, multicenter studies will help to define the role of stress-management interventions in the treatment and course of MS. Furthermore, including outcome measures based on biological and clinical markers of disease will prove useful in understanding potential underlying mechanisms.