title: Counterbalancing patient demands with evidence: results from a pan-Canadian randomized clinical trial of brief supportive-expressive group psychotherapy for women with systemic lupus erythematosus.
abstract: OBJECTIVE
  To evaluate the effect of Brief Supportive-Expressive Group Psychotherapy as an adjunct to standard medical care in reducing psychological distress, medical symptoms, and health care costs and improving quality of life in women with systemic lupus erythematosus (SLE).
  
  
  METHODS
  A randomized clinical trial was conducted with 133 SLE female patients from 9 clinics across Canada. Clinical and psychosocial measures were taken at baseline, posttreatment, and 6 and 12 months posttreatment. Outcomes assessed were psychological distress, quality of life, disease activity, health service utilization, and diminished productivity.
  
  
  RESULTS
  Intention-to-treat analyses revealed that there were no clinically important group differences on any of the outcome measures.
  
  
  CONCLUSIONS
  Although both groups improved over time on several measures (e.g., decreases in psychological distress, stress, and emotion-oriented coping), these changes could not be attributed to the psychotherapeutic intervention. Thus, evidence does not support the referral of these patients to this type of intervention.
authors.affiliation: Montreal General Hospital Research Institute, Department of Medicine, McGill University, Quebec, Canada. patricia.dobkin@mcgill.ca
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Dobkin
authors.forename: Deborah
authors.initials: D
authors.lastname: Da Costa
authors.forename: Lawrence
authors.initials: L
authors.lastname: Joseph
authors.forename: Paul R
authors.initials: PR
authors.lastname: Fortin
authors.forename: Steven
authors.initials: S
authors.lastname: Edworthy
authors.forename: Susan
authors.initials: S
authors.lastname: Barr
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ensworth
authors.forename: John M
authors.initials: JM
authors.lastname: Esdaile
authors.forename: André
authors.initials: A
authors.lastname: Beaulieu
authors.forename: Michel
authors.initials: M
authors.lastname: Zummer
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Senécal
authors.forename: Jean-Richard
authors.initials: JR
authors.lastname: Goulet
authors.forename: Denis
authors.initials: D
authors.lastname: Choquette
authors.forename: Eric
authors.initials: E
authors.lastname: Rich
authors.forename: Doug
authors.initials: D
authors.lastname: Smith
authors.forename: Alfred
authors.initials: A
authors.lastname: Cividino
authors.forename: Dafna
authors.initials: D
authors.lastname: Gladman
authors.forename: Yvan
authors.initials: Y
authors.lastname: St-Pierre
authors.forename: Ann E
authors.initials: AE
authors.lastname: Clarke
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003865:Major Depressive Disorder / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008180:Lupus Erythematosus, Systemic / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life; D012944:Social Support; D014481:United States