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Rheumatology Advance Access published online on February 28, 2003
Rheumatology, doi:10.1093/rheumatology/keg144
Rheumatology © British Society for Rheumatology 2003; all rights reserved
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© 2003 British Society for Rheumatology

Original Papers

Long-term efficacy of a cognitive behavioural treatment from a randomized controlled trial for patients recently diagnosed with rheumatoid arthritis

L. Sharpe 1*, T. Sensky 2, N. Timberlake 3, B. Ryan 3, S. Allard 3

1 School of Psychology, Clinical Psychology Unit F12, University of Sydney, Australia
2 Imperial College of Science, Technology and Medicine, London, UK
3 West Middlesex University Hospital, Isleworth, UK

* Corresponding author. E-mail: louises{at}psych.usyd.edu.au.

Received 19 March 2001 ; accepted 4 September 2002

Abstract

Objectives. This study examined the long-term efficacy of a cognitive behavioural intervention for patients with recent-onset, seropositive rheumatoid arthritis (RA).

Methods. Fifty-three consecutive patients with less than a 2-yr history of classic or definite RA were recruited into the trial. All participants received routine medical management during the study, and half were randomly allocated to receive an 8-week adjunctive psychological intervention. All assessments were conducted blind to the allocation. This paper reports intention-to-treat analyses of the 18-month follow-up.

Results. Consistent with short-term results, significant differences were found between the groups in depressive symptoms. The intervention group maintained improvements in joint function, although those in routine care made similar improvements over the ensuing 18 months. At follow-up, group differences emerged for disability and anxiety.

Conclusions. These results indicate that cognitive behavioural intervention offered as an adjunct to standard clinical management early in the course of RA is efficacious in producing improvements in both psychological and physical indices. Furthermore, improvements appear to increase 18 months after a brief, time-limited psychological treatment.

Key words: Arthritis, Rheumatoid, Psychological intervention, Cognitive behavioural treatment, Depression, Outcome assessment.
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