Background

Anxiety is common in patients with rheumatoid arthritis (RA) and associated with worse RA outcomes. This study assessed the feasibility and preliminary health impacts (mental and physical) of a non-therapist assisted, online mental health intervention targeting anxiety in this population.

Methods

Participants with confirmed RA and elevated anxiety symptoms were enrolled into the Worry and Sadness program, an Internet-based cognitive-behavioral therapy (iCBT) intervention for anxiety and depression shown to be effective in the general population. Validated self-report measures of anxiety, depression, pain interference, fatigue, physical health-related quality of life, functional status, and patient-reported disease severity were collected at baseline, post-intervention, and at three-month follow-up. Emotional distress scores were tracked between lessons. Participants provided qualitative feedback in writing post-intervention.

Results

We analyzed the responses of 34 participants; the majority was female (86%) and the mean age was 57 (SD = 13). Of these, 80% (n = 28) completed the study in its entirety. Among these completers, 94.1% described the program as worthwhile. We found statistically significant improvements in anxiety, depression and fatigue from baseline to three-month follow-up, with small to large effect sizes (d = 0.39–0.81). Post-hoc analyses revealed that statistically significant change occurred between baseline and post-intervention for anxiety and depression and was maintained at three-month follow-up, whereas statistically significant change occurred between baseline and three-month follow-up for fatigue. Statistically significant reductions in emotional distress occurred across the program, with a large effect size (d = 1.16) between the first and last lesson.

Conclusion

The Worry and Sadness program shows promise as a feasible resource for improving mental health in RA.

中文翻译：

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支持非治疗师辅助、基于互联网的认知行为疗法 (iCBT) 干预类风湿性关节炎患者的心理健康

背景

焦虑在类风湿关节炎 (RA) 患者中很常见，并且与较差的 RA 结果相关。本研究评估了针对该人群焦虑的非治疗师辅助的在线心理健康干预的可行性和初步健康影响（心理和身体）。

方法

确诊为 RA 且焦虑症状升高的参与者参加了“焦虑和悲伤”计划，这是一种基于互联网的针对焦虑和抑郁的认知行为疗法 (iCBT) 干预，被证明对普通人群有效。在基线、干预后和三个月的随访中收集了经过验证的焦虑、抑郁、疼痛干扰、疲劳、身体健康相关的生活质量、功能状态和患者报告的疾病严重程度的自我报告测量值。在课程之间跟踪情绪困扰分数。参与者在干预后的写作中提供了定性反馈。

结果

我们分析了 34 名参与者的反应；大多数为女性（86%），平均年龄为 57 岁（SD = 13）。其中，80% ( n  = 28) 完成了整个研究。在这些完成者中，94.1% 的人认为该计划是值得的。我们发现，从基线到三个月的随访，焦虑、抑郁和疲劳的改善具有统计学意义，效应量从小到大（d = 0.39–0.81)。事后分析显示，在焦虑和抑郁的基线和干预后之间发生了统计学上的显着变化，并在三个月的随访中保持不变，而在基线和三个月的疲劳随访之间发生了统计学上的显着变化。整个课程的情绪困扰显着减少，第一堂课和最后一堂课之间的效应量很大（d  = 1.16）。

结论

Worry and Sadness 计划有望成为改善 RA 心理健康的可行资源。