Arthritis sufferers who undergo psychological counseling and learn skills for coping with pain have less disability and better quality of life, according to a new systematic review.

Living with the pain of arthritis can lead to depression and isolation. Severely afflicted people are often unable to socialize or participate in favorite activities. Limited mobility and loss of fine-motor function can make hard it to perform everyday tasks, like cooking or getting dressed.

Treatment early on aimed at psychosocial issues could make a big long-term difference for people with arthritis, the reviewers say.

"This early-intervention approach could have many benefits in terms of preventing problems in coping from developing and [then] becoming entrenched," said review co-author Francis Keefe, Ph.D., of Duke University Medical Center.

The review analyzed 27 randomized controlled trials involving 3,409 patients with osteoarthritis or rheumatoid arthritis to look at how psychosocial interventions affected pain.

The review, which is part of a new series, appears in the May issue of the journal Health Psychology. Each evidence-based review centers on a specific psychological assessment or treatment conducted in the context of a physical disease process or risk reduction effort.

Studies in the review paid the most attention to cognitive-behavioral therapy a treatment based on changing unhelpful patterns of thinking for pain management. An important facet of this therapy was training in specific coping skills, such as using relaxation techniques and pacing daily activities.

Other interventions included biofeedback, stress management, emotional disclosure, hypnosis and psychodynamic therapy.

Counseling and coping skills made the greatest difference in quality of life measures: patients who received the interventions reported a significant decrease in anxiety, depression and psychological disabil
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Contact: Lisa Esposito
hbns-editor@cfah.org
Center for the Advancement of Health
10-May-2007