Abstract
BackgroundSystemic Lupus Erythematosus (SLE) is an autoimmune disease which impairs the quality of life. The objective of study was to evaluate the effectiveness of Brief Group Psychoanalytic Psychotherapy to improve quality of life, depression, anxiety and coping strategies in SLE patients.MethodsIn a randomized clinical trial, 80 female SLE patients were allocated into two groups: therapy group (n = 37) and control group (n = 43). Therapy group (TG) attended weekly psychotherapy sessions for 20 weeks; control group (CG) remained on a waiting list. Both groups received standard medical care. Questionnaires and scales were applied by blinded evaluators at baseline (T1) and after 20 weeks (T2): Socioeconomic Status, SLE International Collaborating Clinic/American College of Rheumatology-Damage Index, SLE International Disease Activity, SLE Specific Symptom Checklist, SLE Quality of life, Hospital Anxiety Depression Scale, Coping Strategies Inventory. Intent to treat intra- and inter-group analysis was performed for all variables in T1 and T2 using Qui-square, t-Student, Mann-Whitney and Wilcoxon tests. Analysis of Variance was used to compare categorical variables over time. P < 0.05 was considered significant.ResultsThe mean age of patients was 42 years; 54% were white, with mean disease duration of years 12. At baseline, both groups were homogeneous in all variables, including medications. After 20 weeks of psychotherapy TG was significantly different from CG, with lower frequency of symptoms (p = 0.001), lower level of anxiety (p = 0.019) and depression (p = 0.022), better index in five of six domains of quality of life scale (p ≤ 0.005), including total SLEQOL (p < 0.001) and with higher positive planful problem solving strategy (p = 0.017). No change in disease activity score was observed in both groups.ConclusionsPsychoanalytic psychotherapy was effective to improve many domains of quality of life and one positive coping skill and to reduce SLE symptoms, anxiety and depression levels. Brief group psychotherapy can be a useful tool to complement medical care in SLE patients.Trial registrationNumber NCT01840709.
Highlights
Systemic Lupus Erythematosus (SLE) is an autoimmune disease which impairs the quality of life
The objective of this study was to evaluate the effectiveness of brief group psychoanalytic psychotherapy (BGPP) to improve quality of life, anxiety, depression and coping skills in Brazilian SLE patients
The medications used to control lupus and neuropsychiatric symptoms were similar between groups, with a mean prednisone dosage of 10.38 mg/day
Summary
Systemic Lupus Erythematosus (SLE) is an autoimmune disease which impairs the quality of life. Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. It is more prevalent in females, mainly in the reproductive period of life and has a multifactorial etiology highlighting genetic predisposition, hormonal, environmental and possible infectious factors [1]. Quality of life (QOL) is considered as being healthy, feeling good and being independent and able to work, according to SLE patient reports [5]. Feeling of uncertainty about illness, pain and fatigue are important experiences in SLE patients [8], while illness intrusiveness is a stressor that affects QOL [9]
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