Reducing Depressive Symptoms in Systemic Lupus Erythematosus

摘要 系统性红斑狼疮（SLE）是一种慢性、多系统炎症性疾病， 与严重的心理痛苦有关基于我们团队在狼疮生物医学领域的优势 研究和行为干预，我们建议研究非药物干预，以改善 SLE和共病抑郁症患者的身心健康。 在这个项目中，题为减少SLE患者的抑郁症状，我们将研究 创新的非药物干预，身心技能训练（MBST），以改善心理和 一项随机对照试验（RCT）中SLE患者的身体健康结局。MBST是一种新颖的方法， 结合了认知行为疗法、身心放松技巧和正念成分， 每一种都有益于减轻其它炎性病症中的疼痛和/或痛苦。我们将指派 150例SLE抑郁障碍或亚综合征抑郁患者接受MBST或支持性咨询 控制条件该项目的主要具体目标是评估8节MBST的效果 关于1）心理健康（抑郁症）和2）身体健康（疼痛，疲劳和与健康相关的质量）的计划 life）.此外，我们将探讨MBST干预对1）新的SLE生物标志物的影响， 炎症和免疫功能：细胞结合补体激活产物，在我们的研究中心开发，2） SLE疾病活动的指标，我们将探索3）潜在的治疗调节剂和介质： 基线疼痛和社会经济状况，自我效能和感知压力。我们将评估健康状况 干预后以及6个月和12个月随访时的结果。 SLE是最复杂的自身免疫性疾病之一，抑郁症的发病率最高。MBST 干预有很大的潜力，以解决独特的身体表现和精神痛苦，在这一点上， 患者群体，并可能对患有其他衰弱性慢性疾病的痛苦患者产生广泛影响。

Abstract 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.