Abstract Details

Title ACT with NMOSD: A Targeted Mental Health Intervention for NMOSD Patients and Caregivers

Topic Autoimmune Neurology

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 8-009

Objective Determining effectiveness of a 6-session, telehealth-delivered mental health intervention targeting the psychological burden of NMOSD.

Background

Our team previously defined the extent and nature of the psychological burden of NMOSD for patients and their caregivers (Esiason et al., 2024). With emphasis on improving psychological flexibility, Acceptance and Commitment Therapy (ACT) was predicted to improve depression, anxiety, value-based living, and cognitive fusion/rigidity.

Design/Methods Forty-three adults with NMOSD (76% AQP4+) enrolled in the 6-week ACT w NMOSD trial delivered via HIPAA-compliant Zoom. Caregivers were invited to participate to any extent. All completed self-report measures of anxiety (BAI, GAD-7), depression (BDI-II, PHQ-9), cognitive fusion (CFQ-13), psychological flexibility (AAQ-II), valued living (VLQ), disability status (self-report EDSS), sleep quality (PSQI), fatigue (BFI), and pain (Iowa Pain Thermometer). Repeated measures, linear mixed effect models examined changes in each measure, controlling for age, sex, disability, AQP4.

Results Participants were mostly female (84%) and Caucasian (56%), with baseline mild depression (mean BDI-II = 16.2 [SD = 8.7]) and moderate anxiety (mean BAI = 14.3 [SD = 9.3]). Pre-to-post treatment analysis evidenced reduction in depression (BDI-II: 16.2 (13.5, 19.0) to 11.7 (8.9, 14.5) P<.001; PHQ-9: 9.1 (7.5, 10.6) to 6.1 (4.6, 7.7) P<.001) and anxiety (BAI = 14.3 (11.8, 16.9) to 11.8 (9.2, 14.4) P =.043; GAD-7 (7.2 (5.8, 8.7) to 5.2 (3.8, 6.7) P<.009). Parallel improvements in cognitive fusion (CFQ: 39.8 (35.8, 43.9) to 34.1 (30.0, 38.2) P<.001), psychological acceptance (AAQ-II: 20.1 (17.3, 22.9) to 17.2 (14.4, 20.0) P <.004), valued living (VLQ: 49.8 (43.7, 55.8) to 59.2 (53.2, 65.3) P<.001), and sleep quality (PSQI: 10.6 (9.4, 11.8) to 8.7 (7.5, 9.9), P<.001). Disability status, pain, fatigue were unchanged. Improvements remained at 3-month follow-up.

Conclusions

ACT w NMOSD is a promising innovative mental health intervention demonstrating improvements in depression, anxiety, cognitive fusion, psychological flexibility, valued living, and sleep quality, including 3-months post-treatment.

Authors/Disclosures
C Virginia OHayer, PhD (Thomas Jefferson University Hospital) PRESENTER	The institution of Prof. OHayer has received research support from Alexion Pharmaceuticals Inc. The institution of Prof. OHayer has received research support from Boomer Esiason Foundation.
Darcy Esiason, LCSW	Mrs. Esiason has received personal compensation for serving as an employee of Boomer Esiason Foundation.
Patrick J. Smith, PhD	Dr. Smith has nothing to disclose.
Emily Wakschal, PsyD	Dr. Wakschal has nothing to disclose.
Charles Peppers	Mr. Peppers has nothing to disclose.
Leigh A. Andrews, PhD	Dr. Andrews has nothing to disclose.
Hallie Kushner, PhD	Dr. Kushner has nothing to disclose.
Chelsi N. Nurse, MS	Ms. Nurse has nothing to disclose.
Wendy Erler, MBA	Mrs. Erler has received personal compensation for serving as an employee of Alexion Astra Zeneca. Mrs. Erler has stock in Alexion Astra Zeneca.
Stephen T. Hattrich (Alexion)	Mr. Hattrich has nothing to disclose.
Ankita Deshpande, MPH	Miss Deshpande has received personal compensation for serving as an employee of Alexion. Miss Deshpande has received personal compensation for serving as an employee of Moderna. Miss Deshpande has stock in Alexion and Moderna .
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
Thomas Leist, MD, PhD, FAAN (Thomas Jefferson University)	Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Leist has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Seono. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Expert Wittness with DHHS HRSA.

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