American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is not an indicated non-pharmacologic treatment option for depression in multiple sclerosis?

1. Individual counseling

2. Group counseling

3. Increased medication dosage

4. Support groups

The correct answer is: Increased medication dosage

In the context of managing depression in patients with multiple sclerosis (MS), non-pharmacologic treatment options focus on psychological and social support methods rather than altering medication. Individual counseling, group counseling, and support groups are all effective non-pharmacologic interventions that provide emotional support, coping strategies, and help with the psychological aspects of living with a chronic illness like MS. Individual counseling is tailored to the individual’s specific needs, allowing for one-on-one support. Group counseling encourages interaction with others who share similar experiences, which can help reduce feelings of isolation and provide a sense of community. Support groups can be beneficial as they create an environment for sharing experiences and learning from others in similar situations, fostering social connections. In contrast, increasing the dosage of medication is a pharmacologic intervention, not a non-pharmacologic treatment. While adjustments to medication can sometimes be necessary for managing depression, this approach falls outside the realm of non-pharmacologic interventions aimed at treating depression specifically in MS patients. Thus, identifying increased medication dosage as not being a non-pharmacologic treatment option is accurate, supporting the distinction between pharmaceutical and therapeutic support options in the management of depression.