The Effectiveness of Psychological Interventions for Rheumatoid Arthritis (RA): A Systematic Review and Meta-Analysis 2023 Nagy et al

Andy

Andy

Retired committee member
Abstract

Rheumatoid arthritis (RA) is a long-term disorder that significantly impairs somatic, emotional, and psychological functioning. The objective of this review is to identify, appraise, and synthesize the effects of psychological interventions (e.g., cognitive behavioral therapy (CBT), emotional disclosure (ED), group therapy (GT), mindfulness (M), patient education (PE), and relaxation (R)) on biopsychosocial outcomes in the treatment of rheumatoid arthritis (RA).

A systematic search of all relevant existing randomized clinical trials (RCTs) was conducted using the following online bibliographic databases: JSTOR, PubMed, PsycNET, and The Cochrane Library. Reference lists were searched for additional reports. The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the risk of bias in the included studies. After the selection process, 57 articles were included and 392 were excluded. Three separate meta-analyses were conducted involving psychological interventions as the main variables, showing: (1) significant positive medium effect sizes for average values (Hedges-g = 0.399, Z = 0.399, p = 0.009); (2) significant positive large effect sizes for maximum values (Hedges-g = 0.856, Z = 4.223, p < 0.001); and (3) non-significant results for minimum values (Hedges-g = −0.047, Z = −0.335, p = 0.738). These results demonstrate that, when grouped, psychological interventions are, on average, moderately effective in treating RA.

Overall, this review shows consistent, supportive evidence that psychological interventions can significantly contribute to the standard medical care of RA patients. However, more high-quality, large-sample RCTs still need to confirm these findings.

Open access, https://www.mdpi.com/2075-1729/13/3/849
 
The review said:
By confirming that psychological interventions improve the condition of patients to such a large extent, we can assume that psychological factors are also behind and prone to the development of the disease
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No, you cannot assume this. In fact it makes no sense at all. This is a basic logical fallacy.

The logic is always the same circular nonsense:
  1. Illness has psychological consequences
  2. Addressing those consequences is considered a bit helpful, maybe, by some
  3. The illness has a psychological cause
Lots of assumptions in BPSland:
Assuming that psychological interventions can influence physiological changes, our results further prove that psychological factors are closely associated with RA
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Fully generic assumptions. They keep saying this is effective, but all they have is speculation that it could be effective, if they could simply find the right combination of words and rituals.

Narrative-driven faith-based medicine, it's exactly as bad as it sounds.
 
"Abstract

Rheumatoid arthritis (RA) is a long-term disorder that significantly impairs somatic, emotional, and psychological functioning. The objective of this review is to identify, appraise, and synthesize the effects of psychological interventions (e.g., cognitive behavioral therapy (CBT), emotional disclosure (ED), group therapy (GT), mindfulness (M), patient education (PE), and relaxation (R)) on biopsychosocial outcomes in the treatment of rheumatoid arthritis (RA)."

If you needed any evidence of how poor this approach can get --- not my thing but there is an autoimmune form which is treated using immuno-suppressants --- as per Jonathan -- turns out he should have tried CBT+++
 
Reading the first two sentences (paragraph) was enough --- but read on "The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the risk of bias in the included studies." The second paragraph builds on the first ---
 
rvallee said:
No, you cannot assume this. In fact it makes no sense at all. This is a basic logical fallacy.

The logic is always the same circular nonsense:
  1. Illness has psychological consequences
  2. Addressing those consequences is considered a bit helpful, maybe, by some
  3. The illness has a psychological cause
Lots of assumptions in BPSland:

Fully generic assumptions. They keep saying this is effective, but all they have is speculation that it could be effective, if they could simply find the right combination of words and rituals.

Narrative-driven faith-based medicine, it's exactly as bad as it sounds.
Click to expand...


Don't forget the loop where the existence of these people and their 'research' (read marketing as it is those who are delivering said 'therapy' doing their own 'research') creates psychological misery either directly - by conversion courses and rumour-mill misinformation or indirectly by taking funding that could be going on providing solutions, or interfering with relationships meaning others are less willing to help with providing support for situational issues. Then offers 'calm down dear' techniques for dealing with said psychologically unsustainable without harm situations.

It is like if someone offering a drug was allowed to create the problem that the drug claimed to solve that was, if existent at all, tangential to the original illness then claims 'it could be the underlying cause'. Such as imagine if it were hair thickening meds/shampoo/matras and they were allowed to go into newspapers and medias saying everyone with gout has thin hair so everyone stared at the hair of people with gout, on top of their misery of their painful foot.. so most of them eventually thought I'll try this in an attempt to feel less self-conscious about the apparently thin hair everyone now seems to think I have.

When the truth is everyone just stopped hassling them about their hair because they finally got the message if they were already trying that then they'd better shut up as it is insensitive. And they say well yes I guess it makes me feel a bit better according to the survey that doesn't offer a lot of options - ergo those offering said survey claim that maybe gout is caused by some deficiency of whatever is in their meds/shampoo/mantras.
 
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