Systemic lupus erythematosus (SLE) is a chronic, multisystemic inflammatory disease that is frequently associated with significant psychological suffering. Building upon our team's strengths in lupus biomedical research and behavioral interventions, we propose to study a non-pharmacologic intervention to improve mental and physical health of patients with SLE and co-morbid depression. In this project, entitled, Reducing Depressive Symptoms in SLE, we will investigate the efficacy of an innovative non-pharmacologic intervention, Mind-Body Skills Training (MBST) for improving mental and physical health outcomes in SLE in a randomized controlled trial (RCT). MBST is a novel approach that combines cognitive-behavioral therapy methods, mind-body relaxation skills, and mindfulness components, each of which is beneficial for reducing pain and/or distress in other inflammatory conditions. We will assign 150 SLE patients with depressive disorder or subsyndromal depression to MBST or to a supportive counseling control condition. The primary specific aims of the project are to evaluate the effects of the 8-session MBST program on 1) mental health (depression) and 2) physical health (pain, fatigue, and health-related quality of life). Additionally we will explore the effects of the MBST intervention on 1) novel SLE biomarkers of inflammation and immune function: cell-bound complement activation products, developed at our site, 2) measures of SLE disease activity, and we will explore 3) potential treatment modifiers and mediators: baseline pain and socioeconomic status, and self-efficacy and perceived stress. We will evaluate health outcomes after the interventions and at 6- and 12-months follow-up. SLE is one of the most complex autoimmune diseases, with one of the highest rates of depression. The MBST intervention has strong potential for addressing the unique physical manifestations and mental suffering in this patient group, and may have broad impact on distressed patients with other debilitating chronic diseases.

Public Health Relevance

Depressive disorders are very common in patients with chronic inflammatory diseases, including Systemic Lupus Erythematosus (SLE). We will evaluate the effects of a novel non-pharmacologic intervention, Mind- Body Skills Training (MBST), for improving mental and physical health in SLE patients with comorbid depression. If MBST is beneficial for SLE, which is one of the most complex and devastating autoimmune diseases, the intervention may have broad health impact on patients suffering from other debilitating chronic illnesses as well.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR057338-05
Application #
8471573
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Serrate-Sztein, Susana
Project Start
2009-07-01
Project End
2014-05-31
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
5
Fiscal Year
2013
Total Cost
$307,771
Indirect Cost
$104,622
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Morone, Natalia E; Greco, Carol M; Rollman, Bruce L et al. (2012) The design and methods of the aging successfully with pain study. Contemp Clin Trials 33:417-25
Greco, Carol M; Li, Tracy; Sattar, Abdus et al. (2012) Association between depression and vascular disease in systemic lupus erythematosus. J Rheumatol 39:262-8