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Unit Management of Depression of Patients with Multiple Sclerosis Using Cognitive Remediation Strategies: A Preliminary Study

The Boston Home, Arbour SeniorCare, Dorchester, Massachusetts

David J. Pittenger

Department of Psychology, The University of Tennessee at Chattanooga, Chattanooga, Tennessee

Cheryl S. Weinstein

Beth Israel Medical Center, Harvard Medical School, Boston, Massachusetts

Multiple sclerosis (MS) is a chronic, often progressive neurologic disorder char acterized by cerebral and spinal cord lesions. Patients with advanced MS often re quire continuous supervision in a long-term skilled nursing facility. Many of these pa tients experience clinical levels of depression. For this experiment, we randomly assigned MS patients living in a skilled nursing facility to either a control condition or an extended treatment protocol. The protocol consisted of assigning individual cer tified nursing assistants (CNAs) to each patient, in-service training for the CNAs, and the use of memory notebooks. All patients completed the short version of the Beck Depression Inventory and several measures of cognitive functioning at the start and end of the study. The results indicate statistically and clinically significant improve ments in the depression of patients in the treatment but not in the control condi tion. These results led to recommendations for the treatment of MS patients living in long-term skilled nursing facilities and for additional research. Key Words: Multiple sclerosis—Long—term care—Depression—Memory notebooks—Cognition.

Neurorehabilitation and Neural Repair, Vol. 15, No. 1, 9-14 (2001)
DOI: 10.1177/154596830101500102


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