E077 What is the impact of psychosocial interventions to prevent anxiety and/or depression in people with inflammatory rheumatological conditions? A systematic review

Gray, Lauren; Corp, Nadia; Bjorklund, Matilda; Kingstone, Tom; Chew-Graham, Carolyn; Hider, Samantha

Abstract

Background/Aims Common mood problems such as anxiety and depression are associated with poorer outcomes for people with inflammatory rheumatological conditions. There is increasing interest in investigating whether psychosocial interventions can prevent anxiety and depression in people with long term conditions (LTCs), with some evidence of efficacy in diabetes. We conducted a systematic review of psychosocial interventions to prevent anxiety and/or depression in people with LTCs (defined by Quality and Outcomes Framework) and inflammatory conditions including rheumatoid arthritis (RA), axial spondyloarthritis (AS) and systemic lupus erythematosus (SLE). This analysis aimed to investigate whether interventions that showed effectiveness at preventing anxiety and/or depression, also impacted other disease measures including fatigue, pain, disease activity and physical function. Methods Sub-group analysis of a systematic review examining psychosocial interventions to prevent anxiety and/or depression in people with LTCs (PROSPERO CRD42022333954). Data relating to fatigue, pain and disease activity were extracted. Results Twelve studies looked at preventing anxiety and/or depression in IRCs. Of these, seven studies (SLE n = 3, RA n = 2, AS n = 2) reported a positive effect of the intervention on anxiety and/or depression (e.g., reduction in symptoms or diagnosis of depression or anxiety). These included 5 randomised controlled trials (RCTs) and 2 non-RCTs, with a total number of 494 participants. Interventions that reported positive effects on preventing anxiety and/or depression also reported a positive impact on fatigue with participants reporting reduced fatigue. Four studies included fatigue as a secondary outcome, three demonstrated improvements. Six studies included pain as a secondary outcome, of these only one reported a reduction in pain. There was mixed evidence for the effects on physical functioning with two studies finding improvements in functional capacity including mobility; two studies reported no improvement. Six studies examined patient reported disease activity measures (e.g., erythrocyte sedimentation rate [ESR], Ritchie Articular Index [RAI], C-reactive proteins [CRP] & Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]) with five reporting no improvements in disease activity measures (using ESR, CRP or SLE disease activity index). One study showed a positive effect on BASDAI. The majority of disease activity outcomes were objective measures such as ESR, RAI or CRP, where reduction and prevention in anxiety/depression symptoms is unlikely to significantly change these physical parameters. However, studies generally scored very low/low certainty of evidence using GRADE informed criteria and had high or unclear risk of bias. Conclusion Interventions that prevent anxiety and/or depression in people with IRCs may also be effective in improving fatigue and physical functioning, which could lead to a better quality of life for people with inflammatory conditions. However, further high-quality studies are needed to determine how to maximise the effectiveness of interventions to prevent anxiety and depression in people with inflammatory rheumatological conditions. Disclosure L. Gray: None. N. Corp: None. M. Bjorklund: None. T. Kingstone: None. C. Chew-Graham: None. S. Hider: None.

Citation

Gray, L., Corp, N., Bjorklund, M., Kingstone, T., Chew-Graham, C., & Hider, S. (2025, April). E077 What is the impact of psychosocial interventions to prevent anxiety and/or depression in people with inflammatory rheumatological conditions? A systematic review. Poster presented at British Society for Rheumatology Annual Conference 2025, Manchester Central Convention Complex, Manchester, England, UK

• Presentation Conference Type: Poster
• Conference Name: British Society for Rheumatology Annual Conference 2025
• Start Date: Apr 28, 2025
• End Date: Apr 30, 2025
• Acceptance Date: Apr 28, 2025
• Online Publication Date: Apr 28, 2025
• Publication Date: Apr 28, 2025
• Deposit Date: Jun 6, 2025
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: Supplement_3
• DOI: https://doi.org/10.1093/rheumatology/keaf142.312
• Public URL: https://keele-repository.worktribe.com/output/1242725
• Publisher URL: https://academic.oup.com/rheumatology/article/64/Supplement_3/keaf142.312/8115019