The Effects of Cognitive-Behavioral Group Therapy on Mental Health and Body Image Concerns in Patients With Systemic Lupus Erythematous

One of the most complex and chronic psychiatric disorders is Systemic Lupus Erythematosus (SLE). SLE is a chronic inflammatory disease that occurs in the form of kidney, blood, heart, pulmonary, neurological, or immunological involvement. Individuals with SLE experience decreased mental health levels and present high anxiety, depression, and physical discomfort. Most neuropsychological manifestations are often critical and present significant adverse impacts on patients' health and quality of life; thus, they require early pharmacotherapy according to each patient's condition. Various pharmacological and non–pharmacological interventions are available for treating these patients; of which, Cognitive–Behavioral Therapy (CBT) has a strong theoretical basis. Thus, this research aimed to investigate the effects of group–based CBT on mental health and body image concerns in patients with SLE.

This was a quasi–experimental study with pretest–posttest and a control group design. The study population consisted of all outpatients with SLE referring to Tehran Rheumatology Clinic in Tehran City, Iran, in summer 2014. Of them, 24 patients were selected by convenience sampling method and randomly divided into the experimental and control groups. The inclusion criteria of this study were having at least 18 years of age, manifesting more than average stress symptoms measured by the relevant questionnaire, and history of >1 year of SLE. The exclusion criteria of the study also included a history of hospitalization in the psychiatric ward and the use of psychiatric drugs. The examined patients completed the Symptom Checklist SCL–90–Revised (SLC–90–R) (Derogatis et al., 1976) and the Body Image Concern Inventory (BICI) (Littleton et al., 2005) at the pretest and posttest stages. The CBT for stress management was performed in the experimental group in 10 weekly sessions for two months. Moreover, at intervals, the research groups received their routine medical treatment. The obtained data were analyzed using descriptive statistics, including mean and standard deviation as well as inferential statistics, like Multivariate Analysis of Covariance (MANCOVA) in SPSS at the significance level of 0.05.

The mean posttest scores of anxiety about body image concerns and mental health, after controlling the pretest scores, were significant in both study groups; thus, the provided CBT stress management training was effective in reducing body image concerns (p<0.001) and improving mental health (p<0.001) in the studied patients with SLE. The effects of anxiety on body image concerns and mental health were measured as 0.39 and 0.22, respectively.

The current study results revealed that group–based CBT could effectively reduce stress and body image concerns and enhance mental health in the investigated patients with SLE.