Digital Psychological Intervention for Inflammatory Rheumatic Diseases: A Pilot Randomized Clinical Trial

1. In patients with inflammatory rheumatic diseases (IRD), digital psychological intervention was associated with improved psychological outcomes and quality of life at 3 months of follow-up.

Evidence Rating Level: 1 (Excellent) 

Inflammatory rheumatic diseases (IRD) are a series of diseases, including rheumatoid arthritis (RA) and psoriatic arthritis (PsA), which are becoming more prevalent. Women are disproportionately affected, specifically more prone to systemic lupus erythematosus (SLE). Although these conditions are characterized as physical, many patients also experience significant psychological challenges, such as anxiety and depression. This eventually contributes to a feedback loop, further intensifying physical symptoms and worsening quality of life. Previous studies have demonstrated the effectiveness of cognitive behavioural therapy (CBT) along with other therapy treatments in managing psychological distress in these patients. However, there have been shortages of mental health treatment available for these patients. This randomized controlled trial sought to address these gaps by assessing the effectiveness of a web-based CBT intervention at reducing psychological distress in patients with IRD. The online questionnaires were sent out at baseline, 6 weeks, and 12 weeks. 102 participants (mean [SD] age, 47.2 [12.9] years; 92 [90.2%] female). Change in psychological distress levels was assessed using the Hospital Anxiety and Depression Scale (HADS-D), and quality of life was assessed using the Assessment of Quality of Life-8 Dimensions (AQoL-8D). There was a significantly greater reduction in psychological distress (least-squares mean difference, -3.60 [1.07]; 95% CI, -5.73 to -1.47; P<.001; Cohen d=-0.71) and improvement in quality of life (least-squares mean [SE] difference, 0.04 [0.02]; 95% CI, 0.00-0.09; P=.047; Cohen d=0.49) in the intervention group compared to the control group at follow up. Overall, this study found that the use of online therapy was associated with a reduction in psychological distress and an improvement in quality of life.  

Click to read this study in JAMA Network Open

Image: PD

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