[Behavioral training as additional therapy approach for rheumatoid arthritis].
BACKGROUND
In addition to pharmacotherapy and patient education, guiding patients to an optimal psychological coping with the disease is part of a comprehensive management. Data on the effectivity of the numerous psychosocial interventions are sparse and the outcome parameters are not well-defined.


OBJECTIVE
Introduction and differentiation of cognitive behavioral and mindfulness-based interventions offered to patients with rheumatoid arthritis with the target of improving resilience.


METHODS
Narrative description of the principle of mindfulness and therapeutic concepts, such as mindfulness-based stress reduction. Analysis of published data concerning the effectivity of such psychoeducative training methods in patients with rheumatoid arthritis.


RESULTS
Outcome parameters, such as pain and quality of life can be positively influenced by cognitive behavioral therapy and mindfulness-based stress reduction to a similar extent. Long-term outcomes, such as body function, participation and avoidance of disability have not yet been investigated.


CONCLUSIONS
Interventions aiming at the sustained improvement of resilience and health-related well-being certainly seem to be worthwhile, especially for potentially destructive chronic arthritis. Rational analysis of the effectivity of psychosocial training concepts need to take many covariables into consideration, such as disease duration, individual-related factors, medication and adverse events as well as comorbidities.
III. Med. Abteilung für Innere Medizin und Psychosomatik, Krankenhaus der Barmherzigen Schwestern Wien, Stumpergasse 6, 1060, Wien, Österreich, monika.graninger@bhs.at.
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Graninger
D000203:Activities of Daily Living / Q000523:psychology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D010146:Pain / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome