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Cognitive-behavioral treatment in unselected rheumatoid arthritis outpatients.

14 Aug
Cognitive-behavioral treatment in unselected rheumatoid arthritis outpatients.
A study of 55 patients in a rheumatological outpatient clinic at the University of Goettingen, Germany, looked at the effectiveness of adjunctive cognitive-behavioral treatment, as compared to standard care alone, in unselected rheumatoid arthritis outpatients. Effects on disease activity, pain intensity, psychological symptoms, and coping were observed. A prospective randomized control design was used. Change in medication during treatment was controlled by matching therapy- and control-group subjects according to this change in medication, sex, age, duration of disease, and functional class. All subjects received routine care by the rheumatologists and routine medical treatment. Cognitive-behavioral treatment subjects (n = 19) received adjunctive standardized cognitive-behavioral group treatment with 12 weekly sessions. Subjects mostly demonstrated an increasing disease activity during treatment, and change in medication during treatment was necessary in some patients. In the cognitive-behavioral treatment group the course of rheumatoid arthritis seemed less progressive than in the control group. The core effects of cognitive-behavioral treatment had to do more with improved coping, emotional stabilization, and reduced impairment than with reduced pain intensity. Passive, emotion-focused coping, helplessness, depression, anxiety, affective pain, and fluctuation of pain were reduced, and "Acceptance of Illness" was improved. The study concludes that cognitive-behavioral therapy was an effective adjunct to standard treatment of rheumatoid arthritis outpatients in an unselected sample with increasing disease activity and with comparable changes in medication during treatment. The investigators recommend cognitive-behavioral treatment as an desirable adjunct to standard medical treatment of rheumatoid arthritis.

Citation: Leibing E, Pfingsten M, Bartmann U, Rueger U, Schuessler G, Cognitive-behavioral treatment in unselected rheumatoid arthritis outpatients. Clinical Journal of Pain 1999 Mar;15(1):58-66.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award