Session Type: Abstract Submissions
Session Time: 5:30PM-7:00PM
Methods: The treatment involved 6 one-hour individual sessions held weekly with a doctoral level psychologist who specializes in CBT. Parent/caregivers were involved in 2 of the 6 sessions and participated in weekly check-ins. The goal of the sessions was to improve coping with pain symptoms, depressive symptoms, and fatigue. Content included psychoeducation (i.e., how fatigue, pain, and mood symptoms relate to cSLE), training in cognitive (i.e., problem solving, cognitive restructuring) and behavioral strategies (e.g., activity pacing, behavioral activation) aimed at improving symptoms. At baseline and post-treatment, participants completed self-report outcome measures on pain levels (Visual Analog Scale; 0-10 VAS), fatigue (PROMIS Pediatric Fatigue- short form), depressive symptoms (Children’s Depression Inventory 2; CDI 2), and HRQOL (PedsQL Generic Core Scales).
Results: All participants were diagnosed with cSLE by their rheumatologist. Five of 8 participants (mean,range (years): 15.2/14-17) have completed the 6-session intervention, with 2 participants mid-treatment. At baseline, the average VAS score was 3.4, PROMIS Fatigue score was 18.8, and CDI score was 14.75. For treatment completers, PROMIS Fatigue reduced by 5 points (Z=-2.023, p>0.05), and CDI reduced by 3.5 points (Z=-1.841, p=.066). VAS and PedsQL scores did not change significantly post treatment.
Conclusion: Participants who completed CBT experienced significant reductions in symptoms of fatigue and depressive symptoms at post treatment. These preliminary results indicate that CBT may be a feasible and potentially beneficial self-management approach for adolescents who are experiencing mood, and/or fatigue symptoms associated with cSLE. Although there was not an immediate effect on pain or HRQOL at post-treatment, improving patient symptoms such as mood and fatigue may ultimately improve functioning and impact these domains over time.
To cite this abstract in AMA style:Warner J, Moorman E, Cunningham N, Wiley K, Watts A, Kashikar-Zuck S, Brunner H. Development of Cognitive Behavioral Therapy (CBT) for Childhood-onset Systemic Lupus Erythematosus (cSLE) Treatment [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 4). https://acrabstracts.org/abstract/development-of-cognitive-behavioral-therapy-cbt-for-childhood-onset-systemic-lupus-erythematosus-csle-treatment/. Accessed June 6, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/development-of-cognitive-behavioral-therapy-cbt-for-childhood-onset-systemic-lupus-erythematosus-csle-treatment/