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.
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.
Dobkin
Patricia L
PL
Montreal General Hospital Research Institute, Department of Medicine, McGill University, Quebec, Canada. patricia.dobkin@mcgill.ca
Da Costa
Deborah
D
Joseph
Lawrence
L
Fortin
Paul R
PR
Edworthy
Steven
S
Barr
Susan
S
Ensworth
Stephanie
S
Esdaile
John M
JM
Beaulieu
André
A
Zummer
Michel
M
Senécal
Jean-Luc
JL
Goulet
Jean-Richard
JR
Choquette
Denis
D
Rich
Eric
E
Smith
Doug
D
Cividino
Alfred
A
Gladman
Dafna
D
St-Pierre
Yvan
Y
Clarke
Ann E
AE
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