Efficacy of cognitive-behavioral therapy for adherence, depression and negative illness representations in rheumatoid arthritis patients: A randomized controlled trial

Background: Rheumatoid arthritis (RA) is a chronic inflammatory polyarthritis with multiple clinical symptoms and psychological problems, such as depression. Psychotherapy can play an important role in achieving therapeutic goals. Objective: The purpose of this study was to determine the effect of cognitive behavioral therapy for adherence, depression (CBT-AD) and negative illness representations in people with RA. Methods: A clinical trial was conducted in Rheumatology’s clinic in a Shariaty hospital in Tehran during 2016-2017, Iran. Then, among 151 patients with rheumatoid arthritis, 28 patient were selected using the sampling judgment and half of them were randomly assigned to the CBT-AD (14 patients) and the others were in the control group (14 patients).  Psychological questionnaires including the illness perception questionnaire-revised, beck depression inventory and general adherence Scale were measured. All data were analyzed by independent t-test, Chi-square and multivariate covariance analysis. Findings: The results showed that the baseline, post-test score between two intervention and control groups in three dimensions of illness representations (P<0.001), depression (P<0.001) and adherence (P<0.001) were statistically significant. Conclusion: CBT-AD is a potentially efficacious approach for individuals with RA struggling with depression at the same time, which leads to a reduction in depression, an increase in adherence and correction of negative illness representations.