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Evid Based Nurs 4:120 doi:10.1136/ebn.4.4.120
  • Treatment

Cognitive behavioural therapy plus medical management reduced depression and joint inflammation in rheumatoid arthritis


 
 QUESTION: Does the addition of cognitive behavioural therapy (CBT) to medical management relieve symptoms and reduce disability and psychological distress in patients with recent onset rheumatoid arthritis (RA)?

Design

Randomised {allocation concealed}*, blinded (outcome assessor), controlled trial with 6 months of follow up.

Setting

Rheumatology clinics at 3 hospitals in or near London, UK.

Patients

56 patients who were 18–75 years of age, had had definite or classic RA for <2 years, and tested seropositive for RA. Exclusion criteria were history of mental illness or alcohol or drug abuse, or insufficient fluency in English. Follow up was 80% (mean age 55 y, 71% women, mean duration of illness 12.6 mo).

Intervention

Patients were allocated to routine medical management and CBT (n=23) or routine medical management alone (n=22). 2 psychologists provided CBT according to a treatment manual during eight …

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