The effect of cognitive behavior therapy in patients with rheumatoid arthritis

Abstract

Summary-In order to examine the effectiveness of cognitive behavioral therapy for patients with rheumatoid arthritis (RA) three patients groups were studied; a cognitive behavioral therapy group (CBT), an occupational therapy group (OT), and a waiting-list control group. The CBT received a comprehensive, 10-session treatment package that taught progressive relaxation, rational thinking and the differential use of pain coping strategies, CBT resulted in minor changes in pain coping behavior at posttreatment, while CBT and OT showed an increase of knowledge of RA. N o therapeutic effects with regard to health status were demonstrated at posttreatment and at 6 months follow-up. Clinical and laboratory measures of disease activity revealed progressive deterioration of the patients during the course of the study. It is suggested that the ineffectiveness of CBT might be due to the progressive course o f RA in the patients studied, as well as to the rather small changes in coping behavior. I N T R O D U C T I O

Psychological interventions for rheumatoid arthritis: A meta‐analysis of randomized controlled trials

“…Only 1 trial (43) described a proper method of allocation concealment. Five studies (20%) (26,31,34,42,44) did not adequately describe the control condition (e.g., simply referred to a control group but did not indicate the extent, if any, of contact with researchers or clinical staff). Finally, the majority of trials (92%) reported comparing baseline characteristics of treatment and control groups and 72% controlled for baseline differences in the statistical analysis (for which an additional quality point was given).…”

Occupational therapy for rheumatoid arthritis: A systematic review

“…Four studies on the effectiveness of comprehensive OT were identified (Table 3): 3 RCTs (14,41,54) and one OD (55). One of the RCTs (41) had high methodologic quality.…”

“…Within the category "comprehensive OT," the results of three studies (14,41,54) instead of one contribute to the best evidence synthesis. Two studies (14,54) found no significant results on functional abilities, whereas one (41) did. As a result, the findings of "limited evidence" changes to "indicative findings" for the evidence of effectiveness of OT on functional ability.…”

Psychological interventions for rheumatoid arthritis: Examining the role of self‐regulation with a systematic review and meta‐analysis of randomized controlled trials

“…However, since all outcomes were measured using self-report questionnaires that vary in their respective sensitivities to change, the relationship between statistical and clinical significance should be examined on a case-by-case basis. Furthermore, when examining these results, it should be noted that several studies yielded negative effect sizes for various outcomes, indicating that psychological treatments are not beneficial for all patients or for all outcomes (8,31,36,38,42,51).…”