Autoimmune Diseases Unit, Internal Medicine Service, University Hospital Virgen de Las Nieves, Granada, Spain.
Psychother Psychosom. 2010;79(2):107-15. doi: 10.1159/000276370. Epub 2010 Jan 20.
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.
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.
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.
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.
慢性压力通过影响狼疮患者的身体和心理状况，使他们的生活质量（QOL）恶化。本研究旨在调查认知行为干预对一组高日常压力的狼疮患者的疗效。
将 45 名患有狼疮且压力水平较高的患者随机分配至对照组（CG）或治疗组（TG）；他们接受认知行为疗法（CBT），共包括连续 10 周的 10 次治疗。在基线、3、9 和 15 个月时评估以下变量：（1）压力、焦虑、抑郁；（2）系统性红斑狼疮疾病活动指数、躯体症状、发作次数；（3）抗双链 DNA 抗体、补体 C3 和 C4 片段；（4）QOL。采用重复测量的多变量分析和各种方差分析进行分析。
与 CG 相比，TG 中的抑郁、焦虑和日常压力水平显著降低，TG 中的 QOL 和躯体症状在整个随访期间显著改善。我们没有发现免疫参数有任何显著变化。
CBT 对患有狼疮和高日常压力的患者有效，因为它可以显著降低与狼疮相关的心理障碍的发生率，并改善和维持患者的 QOL，尽管疾病活动指数没有显著降低。
