Cognitive behavioural group therapy to improve patients' strategies for coping with restless legs syndrome: a proof-of-concept trial.
BACKGROUND
Restless legs syndrome (RLS) is a usually chronic disorder accompanied by clinically relevant psychosocial impairment. To date, no psychologically based approach is available to improve the coping strategies and quality of life of RLS sufferers.


OBJECTIVE
To develop cognitive behavioural therapy tailored to this disorder (the RELEGS coping therapy programme) and present the results of this proof-of-concept study.


METHODS
Twenty-five patients (five men, 20 women; 15 medicated, 10 unmedicated; mean (SD) age 56.1 (12.3) years) with subjective psychosocial impairment due to RLS participated in one of three consecutive therapy groups. The severity scales (IRLS and RLS-6) indicated moderate to severe RLS symptoms at baseline. Exclusion criteria were secondary RLS, foreseeable change of RLS medication during the study period, serious physical or psychiatric comorbidity, and severe cognitive deficits. Each group took part in eight group sessions (90 min each with a break).


RESULTS
At the end of the treatment, both the RLS-related quality of life and the mental health status of the subjects had improved significantly (QoL-RLS scale: from 28.6 (12.8) to 23.4 (13.1); SCL-90-R: from 51.3 (37.0) to 45.9 (32.9)). The improvement remained at follow-up 3 months later. Subjective ratings of RLS severity had improved at the end of therapy and at follow-up. Psychometric scales not specific for RLS-related impairment remained unaffected by the treatment.


CONCLUSIONS
The study establishes the feasibility and high acceptance of the newly devised therapy programme. The application of RLS-oriented specific psychological strategies is a step toward an integrated treatment approach in RLS.
Hornyak
M
M
Interdisciplinary Pain Centre and Department of Psychiatry and Psychotherapy, University Medical Centre, Breisacher Strasse 64, D-79106 Freiburg, Germany. magdolna.hornyak@uniklinik-freiburg.de
Grossmann
C
C
Kohnen
R
R
Schlatterer
M
M
Richter
H
H
Voderholzer
U
U
Riemann
D
D
Berger
M
M
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D012148:Restless Legs Syndrome / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome