Neuropsychological counseling improves social behavior in cognitively-impaired multiple sclerosis patients

We studied the effectiveness of a newly-developed cognitive-behavioral inte rvention in 15 patients with marked cognitive impairment and behavior disor der. The design was a single-blind test of a neuropsychological interventio n, with pre- and post-treatment assessments of personality and social behav ior. MS patients underwent neurological examination and neuropsychological testing at baseline. The patients were then randomly assigned to neuropsych ological counseling or standard non-specific supportive psychotherapy The a ctive 12-week treatment emphasized enhancement of insight through education , social skills training, and behavior modification. All patients were re-e xamined within 2 weeks of the termination of treatment Neuropsychological t echnicians were blind to treatment condition. Both groups showed evidence o f cognitive impairment and personality/behavior disorder prior to treatment and were well matched on demographic disability, and cognitive measures. P atients who underwent neuropsychological counseling showed significant posi tive response on measures of social behavior (e.g. excessive ego-centric sp eech) compared to those who underwent standard counseling. We conclude that these data support the use non-pharmacological, neuropsychological counsel ing in patients with acquired MS-associated behavior disorder.