Reviewer’s report
Title: 
Transdiagnostic Treatment of Emotional Disorders for women with
Multiple Sclerosis:  A Randomized Controlled Trial
Version: 
0 
Date: 
08 Sep 2020
Reviewer's report:
The authors present a very interesting clinical issue, namely Transdiagnostic
Treatment of Emotional Disorders for women with Multiple Sclerosis: A
Randomized Controlled Trial. The study aimed to examine the efficacy of a
group format of the Unified Protocol for the Transdiagnostic treatment of
depression and anxiety disorders in females with MS. The manuscript is
relatively well written, although needing some wording improvement in some
phrases and some tables need correction too.
I have some major and minor concerns to the authors:
Major
Although the manuscript is understandable after its complete reading, the way
the results are presented makes it a little difficult to understand at first sight. For
example, the study compared two patients groups using different treatment
protocols, but both protocols used the same tests. So in the abstract, for example,
perhaps it would be more interesting to highlight only the results by category,
perhaps presenting only the p value and the confidence interval, without
necessarily each test result (F, 
η
2p, Cohen's), which makes it a little tiring to
read, since this comes later more detailed throughout the text. The abstract
should not be tiring to read. 
The abbreviations should always be defined the first time they appear. For
example, PwMS is not defined anywhere in the text
Minor
Introduction 
Page 3, Lines 14-16, 
"Depression is a significant determinant of well-being (Taylor et al., 2018),
affects approximately 75% of PWMS at some point during their disease".
I think it would be better to put a conjunction instead of a comma to link these
two sentences. The authors should choose a unique citation style for all
references. 
Page 3, Lines 48-50, 
"Like in the general population, women's suicide attempts were more than men,
but men's succeed attempts were more". I think that its missing some word like
frequency or prevalence to give a better meaning to this sentence
Page 5, Lines 40
- References format (Garcia-Montojo et al., 2013; Tillack et al., 2013).
Page 6, Lines 52-54
Exclusion criteria included - (b) other chronic physical illnesses - I think that it is
necessary to clarify whic chronical diseases were excluded in the presente study.
(g) moderate to high cognitive impairment or physical disabilities - which
screening tool was used for cognitive impairment and how moderate to high
cognitite impairment was defined? 
Page 9, Lines 33-35
"The participants were informed that they could withdraw the consent or stop
participating, at any point to withdraw" - at any point of the study would fit
better 
Results
Descriptive characteristics at baseline
I think that the description of the results throughout the text does not coincide
much with the data presented in table 1. I suggest reworking this table to adapt it
to the results described throughout the text. If we have two groups, table 1 would
fit better, showing the baseline characteristic compared to two groups
Page 14, Lines 18-20
"Our findings revealed significant changes in depression measure in anxiety
measure and in worry at 3-month follow up in the UP group" - phrase needing a
comma between in depression measure and in anxiety measure 
Page 14, Lines 34-39
"This study develops the UP benefits on difficulties emotion regulation scale
have improved other clinical outcomes" - This sentence is not clear, I think the
authors need to clarify it better
Limitations
Next limitation, the participants were generally well-educated, which can be
enhanced their abilities to gain more the UP.
Although the authors repeated several times that the participants in the present
study were generally well-educated, it would be interesting that in the table 1
(general characteristics), the authors include the mean schooling in completed
years of education of each group.
Reference style
There is a mix of reference styles throughout the text. I think that the authors
have to choice only one reference style according to the journal guidelines. 
Table 1
Marital status, data not presented. Table 1 would fit better if the baseline
characteristics are present comparing the two groups (UP vs TAU)
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes