Effect of psychological intervention on health-related quality of life in people with systemic lupus erythematosus: A systematic review

Abstract

Objective: To objectively evaluate the effectiveness of psychological interventions for improving health-related quality of life in patients with systemic lupus erythematosus (SLE). Design and review methods: Databases including Ovid-Medline, PubMed, Web of Science, EBSCOhost, the Cochrane Library and Embase were electronically searched to identify randomized controlled trials published from inception through November 2013 involving psychological intervention in SLE patients. Studies that measured physiological function, life vitality, depression, pain degree, disease activity, severity of fatigue, and physical and mental component summaries as outcomes were included. Trials involving patients with multiple diseases or received simultaneous psychological interventions or combinations of other interventions were excluded. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted and quantitative analysis was performed with RevMan software (version 5.2). Results: A total of six randomized controlled trials comprising 394 participants were included in the study. Meta-analyses showed that psychological interventions significantly reduced the degree of depression (standard mean difference = −0.44, 95% confidence interval [CI]: −0.78–0.10; P = 0.01] and improved the status of the physical health component summary (mean difference = 8.85, 95%CI: 3.69–14.00; P = 0.00] in SLE patients. However, there was no significant effect of psychological intervention on disease activity, degree of pain, fatigue or the mental health component summary. Conclusions: The results show that psychological interventions can effectively improve the health-related quality of life in patients with SLE. The full benefit and clinical performance of psychological care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.

Keywords

• Psychotherapy
• Randomized controlled trials
• Systemic lupus erythematosus
• Systematic review