| Methods |
A 9‐months prospective randomised controlled trial. Change in medication during treatment was controlled by matching therapy and control group participants according to this change in medication, sex, age, duration of disease and functional class. Medication was not prescribed during treatment. Assessments were done at baseline, and after 3 and 9 months.
Quality: 0/2/1/1 |
| Participants |
118 consecutive outpatients were seen. 63 met the criteria and were included. 55 patients were randomised (although not explicitly stated; could also be 63). 55 patients finished the study and were analysed (I: 19, C: 36). Inclusion: Diagnosis of rheumatoid arthritis (ACR criteria). Exclusion criteria: duration of disease of 0.5 years or less, another severe disease, planned hospitalisation, organic brain syndrome, no pain, or advanced disability (functional class IV). Mean age: 52.7 years (SD: 11.9), 74.5% female. Mean duration of disease: 9.4 years (SD: 9.3). 26 patients (67%) were functional class II and 8 (21%) functional class III. |
| Interventions |
Intervention: Routine care by the rheumatologist and adjunctive standardised cognitive‐behavioural group treatment (5‐7 patients) with 12 weekly 90‐minute manual based sessions, designed after the approach by Turk and Rudy, a common basis for cognitive‐behavioural therapies for pain. The following strategies were included: information an education about the gate‐control theory of pain, the vicious circle of pain, muscular tension, demoralisation, and the rational of the treatment methods; relaxation and imagery; cognitive‐behavioural treatment interventions and pain management strategies; and pleasant activity scheduling. Sessions were led by 2 experienced instructors (> 5 years of psychotherapeutic experience)
Controls: Routine care by the rheumatologist and routine medical treatment (n=36, "change‐in‐medication‐matched control group": n=20) |
| Outcomes |
Included: Pain intensity, Functional capacity (Hannover Functional Ability Questionnaire), Number of swollen joints, State‐Trait Anxiety Inventory, Depression scale, ESR.
Others: Affective pain, CRP, grip strength, Arthritis Helplessness Index, Bernese Coping Modes. |
| Notes |
ACR = American College of Rheumatology
ESR = Erythrocyte Sedimentation Rate
CRP = C‐reactive protein |
