TY - JOUR
T1 - Assessment and treatment of depression in people with multiple sclerosis
T2 - A qualitative analysis of specialist clinicians’ experiences
AU - Marck, Claudia H.
AU - Hunter, Assunta
AU - Butler, Ernest
AU - Allan, Michelle
AU - Edward, Karen-Leigh
AU - Giles, Andrew
AU - Kulkarni, Jayashri
AU - Rajendran, Deepa
AU - Shaw, Sally
AU - Grech, Lisa B.
N1 - Funding Information:
This study was funded by an incubator grant from Multiple Sclerosis Research Australia ( 19-0723 ). CHM was supported by a Fellowship from the National Health and Medical Research Council ( 1120014 ) and Multiple Sclerosis Research Australia ( ID 20-216 ). LG was supported by a Fellowship from Multiple Sclerosis Research Australia ( 20-206 ).
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2022/1
Y1 - 2022/1
N2 - Background: Depression is common in people with multiple sclerosis (MS), with lifetime prevalence estimates between 25 and 50%. Depression is commonly underdiagnosed and undertreated in people with MS. This qualitative study assessed current practices, as well as facilitators and required resources to improve detection and management of depression in people with MS. Methods: MS clinicians living in Australia were recruited through MS healthcare provider clinics and networks for online interviews. Interviews were transcribed and coded in NVivo for framework analysis. Results: Participants included 15 MS specialists: nine nurses and six neurologists. Participants appreciated that depression was a common symptom of MS, and that untreated depression impacted patients’ wellbeing, medication adherence, capacity for self-care, employment, and interpersonal relationships. Participants did not routinely screen for depression and noted that they lack the time and skills to manage depression once identified, most often recommending patients see their general practitioner. Clinicians recognised that people with MS commonly experience barriers to identifying and managing depressive symptoms, however few clinics provide information or discussion about depression as a symptom of MS with patients. Conclusion: Participants indicated a need for evidence-based guidance, more education and training to improve practices including screening for depression, and an urgent need for local referral pathways to affordable and accessible mental health services for people with MS. Findings suggest a need for better collaborative management of depression and improvement of systematic practices related to depression information, screening and treatment support.
AB - Background: Depression is common in people with multiple sclerosis (MS), with lifetime prevalence estimates between 25 and 50%. Depression is commonly underdiagnosed and undertreated in people with MS. This qualitative study assessed current practices, as well as facilitators and required resources to improve detection and management of depression in people with MS. Methods: MS clinicians living in Australia were recruited through MS healthcare provider clinics and networks for online interviews. Interviews were transcribed and coded in NVivo for framework analysis. Results: Participants included 15 MS specialists: nine nurses and six neurologists. Participants appreciated that depression was a common symptom of MS, and that untreated depression impacted patients’ wellbeing, medication adherence, capacity for self-care, employment, and interpersonal relationships. Participants did not routinely screen for depression and noted that they lack the time and skills to manage depression once identified, most often recommending patients see their general practitioner. Clinicians recognised that people with MS commonly experience barriers to identifying and managing depressive symptoms, however few clinics provide information or discussion about depression as a symptom of MS with patients. Conclusion: Participants indicated a need for evidence-based guidance, more education and training to improve practices including screening for depression, and an urgent need for local referral pathways to affordable and accessible mental health services for people with MS. Findings suggest a need for better collaborative management of depression and improvement of systematic practices related to depression information, screening and treatment support.
KW - Depression
KW - Depression screen
KW - Multiple sclerosis
KW - Qualitative
UR - http://www.scopus.com/inward/record.url?scp=85118702017&partnerID=8YFLogxK
U2 - 10.1016/j.msard.2021.103362
DO - 10.1016/j.msard.2021.103362
M3 - Article
C2 - 35158469
AN - SCOPUS:85118702017
SN - 2211-0348
VL - 57
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
M1 - 103362
ER -