Effects of Cognitive Therapy on Immunology and Psychological Wellbeing in Patients with Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is among the most common diseases of the immune system, i.e., dramatically on the rise. The disease is developed when the immune system attacks the cells and tissues of the body, rather than fighting the disease–causing agents, and facilitates the destruction of parts of the body. Despite the high prevalence and severity of the disease, the underlying cause of the disease remains unrecognized. Research suggested that social and physiological stressors, like psychoneuroimmunology, can cause RA; thus, it is essential to pay further attention to psychological issues. This has led to a significant extent of attention paid to different psychotherapy approaches and their effectiveness in improving safety and Psychological Wellbeing (PWB) in patients with RA. Among psychological therapies, cognitive therapies are primarily designed to control and manage stress and anxiety; they can be an appropriate option for managing patients with RA. Therefore, the present study aimed to evaluate the effects of cognitive therapy on immunological parameters and PWB in patients with RA.

This case–control and applied study used an experimental design. The statistical population of the present study was all the patients with RA, referring to Imam Khomeini Hospital in Tehran City, Iran. Of them, 40 patients who met the inclusion criteria were selected by the purposive sampling method. Then, they were randomly divided into the experimental and control groups. To evaluate the effects of cognitive therapy on CRP and ESR, as well as PWB, the study groups were evaluated for these indices before the onset of the experiment; accordingly, cognitive therapy intervention was performed for the experimental group. Finally, in both study groups, the above–mentioned indices were re–evaluated. Additionally, the pretest–posttest results were analyzed using Multivariate Analysis of Covariance (MANCOVA).

The present study data indicated that providing cognitive therapy intervention to the experimental group increased their posttest PWB scores, compared to the control group (p<0.001). Furthermore, this treatment presented significant changes in CRP (p=0.004) and ESR (p<0.001) indices in the experimental group, compared to the controls.

Considering the effectiveness of cognitive therapy on immunological parameters as well as PWB in the examined patients with RA, this therapy can be used as a complementary intervention for this population. Cognitive therapy can also be applied as a preventive measure by identifying patients who present RA symptoms and improve their mental health.