Effects of stress management on clinical outcomes in rheumatoid arthritis

Abstract

Objective. To examine the effects of stressmanagement training on clinical outcomes in persons with rheumatoid arthritis (RA). Methods.Patients with RA (n = 141) were randomly assigned to 1 of 3 groups: a stress management group, an attention control group, or a standard care control group. The stress management and the attention control groups received a 10-week intervention followed by an additional 15-month maintenance phase.Results. The stress management group showed statistically significant improvements on measures of helplessness, self-efficacy, coping, pain, and health status. Selected beneficial effects were still detectable at the 15-month followup evaluation.Conclusion. The data indicated that stress management interventions are capable of producing important clinical benefits for persons with RA.

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

“…Length of the interventions varied from 3 days to 9 months with a mean of 9.8 weeks. One study (38) utilized a "refresher" course following the actual intervention. Nineteen of the 25 studies collected followup data with followup time periods ranging from 2 to 18 months (mean of 8.6).…”

“…Five of the 25 studies (30,37,41-43) described a proper method of randomization (e.g., table of random numbers, computer generated). Patients were deemed to be blind to the treatment condition in 5 trials (27,30,37,38,43), although as noted earlier, such blinding is typically either not possible or not ethical in many behavioral interventions. Following von Tulder et al (20), in studies that utilized an attention control as the placebo condition, we considered patients to be blind if the researchers performed a treatment credibility analysis and there were no significant differences between the intervention or control group in terms of the participants' assessment of credibility.…”

“…In 11 trials (44%) (25,26,29,32,35,36,38,41,43,47,48), the assessor (i.e., data collector) was described as blinded to group assignment. Only 1 trial (43) described a proper method of allocation concealment.…”

“…However, in the case of psychological status (depression) and tender joints, effects became somewhat more pronounced over time. Future trials should explore the potential value of building booster/relapse prevention strategies into the trial designs, as was done by Parker et al in their study (38).…”

The neuroscience and endocrinology of fibromyalgia

“…These protocols have been shown to be effective for patients with rheumatoid arthritis and osteoarthritis in randomized, controlled clinical trials (24,25). Recent studies of cognitive-behavioral therapy (CBT) protocols have shown positive findings in patients with FMS (26).…”