Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial

Abstract

Background: Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. Methods: Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. Results: We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. Conclusions: CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients’ QOL, despite there being no significant reduction in the disease activity index.

Coping and Quality of Life in Patients with Systemic Lupus Erythematosus: A Review

“…However, there is a subset of patients (approximately 40%) that remain in discomfort and they can benefit from psychosocial interventions (Dobkin et al, 2001). None of the studies found significant immunological changes in the index of disease activity (Navarrete-Navarrete et al, 2010;Sohng, 2003).…”

“…The literature reviewed suggests that there is a benefit for patients receiving psychological treatment in coping adjunct with medical treatment, along with achieving effects such as reduction in anxiety and depression (Navarrete-Navarrete et al, 2010).…”

Modificación de la personalidad mediante una terapia cognitivo-conductual de afrontamiento al estrés.

“…Los resultados encontrados mostraron por un lado que la terapia cognitivo-conductual de afrontamiento al estrés disminuyó las puntuaciones en las variables de estrés percibido, vulnerabilidad al estrés, preocupaciones, somatizaciones, sensibilidad interpersonal, depresión, ansiedad y ansiedad fóbica. Estos resultados confirman los hallazgos de otros estudios dirigidos a comprobar la eficacia de esta terapia para reducir los niveles de estrés y el malestar emocional (Navarrete-Navarrete et al, 2010;Peralta-Ramírez et al, 2009). Por otro lado, con respecto a las variables de personalidad también encontramos que tras la terapia se incrementan los niveles de optimismo, extraversión y conciencia/responsabilidad.…”

“…Numerosos estudios han mostrado que mediante terapias cognitivo-conductuales se consigue controlar el estrés, así como variables asociadas a éste: ansiedad (Hofmann y Smits, 2008; Navarrete-Navarrete et al Debido al fuerte impacto que este trastorno puede llegar a suponer en las personas, se han desarrollado programas en diferentes muestras de población tratando de paliar dichas consecuencias (Navarrete-Navarrete et al, 2010; PeraltaRamírez, et al, 2009;. En concreto, Butler, Chapman, Forman y Beck (2006) examinaron 16 meta-análisis de los efectos de la terapia cognitivo-conductual y encontraron mejoras en una gran variedad de problemas entre los que destacaban depresión mayor, trastorno de ansiedad generalizada y trastorno de estrés post-traumático.…”

“…Numerosos estudios han mostrado que mediante terapias cognitivo-conductuales se consigue controlar el estrés, así como variables asociadas a éste: ansiedad (Hofmann y Smits, 2008;Navarrete-Navarrete et al, 2010;Öst, 2008; Peralta-Ramírez, Robles-Ortega, Navarrete-Navarrete y Jimé-nez-Alonso, 2009), depresión (Navarrete-Navarrete et al, 2010;Peralta-Ramírez et al, 2009;Spangler, Simons, Monroe y Thase, 1997), felicidad (Lyubomirsky, King y Diener, 2005;Schiffrin y Nelson, 2010), sentido del humor (Grases, Trías, Sánchez y Zárate, 2010), optimismo (Carver y Scheier, 2002;Shifren y Hooker, 1995), somatizaciones, hostilidad (López, Kasanzew y López, 2007), entre otras.…”