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Group Psychotherapy Reduces Illness Intrusiveness in Systemic Lupus Erythematosus
STEVEN M. EDWORTHY, PATRICIA L. DOBKIN, ANN E. CLARKE, DEBORAH DA COSTA, MARIA DRITSA, PAUL R. FORTIN, SUSAN BARR, STEPHANIE ENSWORTH, JOHN M. ESDAILE, ANDRÉ BEAULIEU, MICHAEL ZUMMER, JEAN-LUC SENÉCAL, JEAN-RICHARD GOULET, DENIS CHOQUETTE, ERIC RICH, DOUG SMITH, ALFRED CIVIDINO, DAFNA GLADMAN, and GERALD M. DEVINS
ABSTRACT.
Methods. Women with SLE recruited from 9 rheumatology centers were randomly assigned to receive either usual care (n = 66) or a 12 week brief supportive-expressive group psychotherapy followed by 3 monthly booster sessions (n = 58). Standard instruments assessed disease activity and damage, illness intrusiveness, and psychological distress at 4 measurement occasions: (1) pretreatment, (2) posttreatment, (3) 6 month followup, and (4) 12 month followup. Results. Analysis of covariance, controlling for disease activity and household income, indicated that women who received brief supportive-expressive group psychotherapy experienced significant reductions in illness intrusiveness for 2 of 3 domains: (1) relationships and personal development and (2) intimacy. Benefits were evident at 6 and 12 month followups. Conclusion. Brief supportive-expressive group psychotherapy facilitates adaptation to SLE by assisting women in reducing illness-induced disruptions into important domains of life experience. (J Rheumatol 2003;30:1011-6) Key Indexing Terms:
QUALITY OF LIFE
From the Department of Rheumatology, University of Calgary, Calgary, Alberta; Division of Clinical Epidemiology, McGill University, Montreal, Quebec; and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Supported by the CANIOS association of Canadian Lupus Investigators; National Health Research and Development Program, Health Canada (research grant 6605-5080-11, Drs. Dobkin and Clarke); McGill University and Lupus Quebec (Drs. Dobkin and Clarke); The Arthritis Society (Senior Research Scholar, Dr. Fortin); Fonds de la Recherche en Santé de Quebec (Senior Career Award, Dr. Dobkin); Conseil Quebecoise de la Recherche Sociale (Postdoctoral Fellowship, D. Da Costa); Canadian Institutes of Health Research (Investigator Award, Dr. Clarke; Senior Investigator Award, Dr. Devins). S.M. Edworthy, MD; S. Barr, MD, Department of Medicine, University of Calgary; P.L. Dobkin, PhD; D. Da Costa, PhD; A.E. Clarke, MD, MSc; M. Dritsa, MEd, Division of Clinical Epidemiology, Montreal General Hospital Research Institute and Department of Medicine, McGill University; J.M. Esdaile, MD, MPH, Division of Rheumatology, Vancouver Hospital, and Arthritis Research Centre of Canada, University of British Columbia, Vancouver, BC; J-L. Senécal, MD; J-R. Goulet, MD; D. Choquette, MD; E. Rich, MD, Division of Rheumatology, Hôpital Notre-Dame, Montreal, Quebec; A. Beaulieu, MD, Division of Rheumatology, Centre Hospitalier de l'Université Laval, Quebec, Quebec; A. Cividino, MD, Division of Rheumatology, McMaster University, Hamilton, Ontario; S. Ensworth, MD, Division of Rheumatology, Vancouver Hospital, Vancouver, BC; D. Smith, MD, Rheumatic Diseases Unit, Ottawa General Hospital, Ottawa, Ontario; M. Zummer, MD, Division of Rheumatology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec; P.R. Fortin, MD, MPH; D. Gladman, MD, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital (University Health Network), Toronto, Ontario; G.M. Devins, PhD, Princess Margaret Hospital (University Health Network) and University of Toronto. Address reprint requests to Dr. S.M. Edworthy, Health Science Centre, Room 442, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. E-mail: sedworth@ucalgary.ca Submitted March 7, 2002; revision accepted November 22, 2002. |