Psychological interventions for rheumatoid arthritis: A meta‐analysis of randomized controlled trials
Abstract
Objective To carry out a systematic review of the literature examining the efficacy of psychological interventions (e.g., relaxation, biofeedback, cognitive-behavioral therapy) in the treatment of rheumatoid arthritis (RA). Methods Studies that met the following criteria were included: random assignment, wait-list or usual care control condition; publication in peer-reviewed journals; treatment that included some psychological component beyond simply providing education information; and separate data provided for patients with RA if subjects with conditions other than RA were included. Two investigators independently extracted data on study design, sample size and characteristics, type of intervention, type of control, direction and nature of the outcome(s). Results Twenty-five trials met the inclusion criteria. Methodologic quality was assessed, and effect sizes were calculated for 6 outcomes. Significant pooled effect sizes were found postintervention for pain (0.22), functional disability (0.27), psychological status (0.15), coping (0.46), and self efficacy (0.35). At followup (averaging 8.5 months), significant pooled effect sizes were observed for tender joints (0.33), psychological status (0.30), and coping (0.52). No clear or consistent patterns emerged when effect sizes for different types of treatment and control conditions were compared, or when higher quality trials were compared to lower quality ones. Findings do, however, suggest that these psychological interven…
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Meta-analyses show that cognitive-behavioral therapy yields moderate to large effects for cognitive coping responses and small to moderate effects for pain outcomes relative to controls.
“A series of meta-analyses summarizing the benefits of CBT has shown that it yields moderate to large effects for cognitive coping responses and small to moderate effects for pain outcomes relative to controls (Astin et al., 2002; Dixon et al., 2007).”
From Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity (2015) · cites this paper as Astin et al., 2002
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“For those with this condition, psychological symptoms are frequent (Astin et al., 2002).”
Background
- Authors
- Astin, J. A., Beckner, W., Soeken, K., Hochberg, M. C., & Berman, B.
- Affiliations
- University of Maryland, Baltimore (US)
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2002-06-05
- Volume
- 47
- Issue
- 3
- Pages
- 291-302
- ISSN
- 0893-7524 (ISSN-L)
- 1529-0123
- OpenAlex
- W2048673746
- Cited by
- 318
- References
- 9
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 6 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 18 · 2019: 9 · 2018: 8 · 2017: 11 · 2016: 14 · 2015: 18 · 2014: 13 · 2013: 20 · 2012: 22
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (5-P50A-T00084-03)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- rheumatoid arthritis, psychological intervention, relaxation, biofeedback, cognitive behavioral therapy, pain, functional disability, coping, self-efficacy, psychological state, tender joint count, adjunctive therapy, disease duration
- MeSH terms
- Arthritis, Rheumatoid, Biofeedback, Psychology, Humans, Relaxation Therapy, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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