Transdiagnostic cognitive behavioral therapy for depression and anxiety in multiple sclerosis: A meta-analytic review.

The present meta-analysis aimed to (a) evaluate transdiagnostic cognitive behavior therapy (TD-CBT) for depression and anxiety in people with multiple sclerosis (pwMS), (b) examine study and treatment characteristics as moderators of treatment effect, and (c) evaluate the quality of available research.Nine electronic databases were searched up to April 24, 2026 for randomized controlled trials (RCTs) examining unified TD-CBT for depression and anxiety in pwMS.Risk of bias was assessed using the revised Cochrane Risk of Bias tool (RoB-2).Across nine eligible RCTs, the controlled effect sizes of TD-CBT were g 5 0.57 (95% confidence interval [0.32, 0.81]) for depressive symptoms and g 5 0.42 (95% confidence interval [0.27, 0.58]) for anxiety symptoms.Effects remained comparable after adjustment for publication bias.Findings suggest a small effect of TD-CBT in reducing depressive and anxiety symptoms in pwMS.However, due to few studies in this area and the overall low quality of available evidence, generalizability of findings is limited.Higher quality RCTs with active treatment controls and longer term follow-up are required to verify the efficacy of TD-CBT, its effectiveness relative to other treatment approaches, and the value of adding MS-specific treatment components. Public Health Significance StatementThis meta-analysis provides preliminary support for the efficacy of transdiagnostic cognitive behavior therapy (TD-CBT) in treating depressive and anxiety symptoms in people with multiple sclerosis.However, findings were based on limited evidence and require further replication.Clinicians delivering mental health care to this population should consider the practical advantages of TD-CBT, particularly of remotely delivered TD-CBT.