Reducing Depressive Symptoms in Systemic Lupus Erythematosus

描述（由申请人提供）：系统性红斑狼疮（SLE）是一种慢性、多系统炎症性疾病，通常与严重的心理痛苦有关。基于我们团队在狼疮生物医学研究和行为干预方面的优势，我们建议研究一种非药物干预来改善狼疮合并抑郁症患者的身心健康。在这个名为“减轻SLE患者抑郁症状”的项目中，我们将在一项随机对照试验（RCT）中研究一种创新的非药物干预——身心技能训练（MBST）对改善SLE患者身心健康结局的疗效。MBST是一种结合了认知行为疗法、身心放松技巧和正念成分的新方法，每一种都有利于减轻其他炎症条件下的疼痛和/或痛苦。我们将分配150名SLE抑郁症或亚综合征性抑郁症患者到MBST或一个支持性咨询控制条件。该项目的主要具体目标是评估8期MBST方案对1)心理健康（抑郁）和2)身体健康（疼痛、疲劳和与健康相关的生活质量）的影响。此外，我们将探索MBST干预对以下方面的影响：1)炎症和免疫功能的新型SLE生物标志物：我们研究中心开发的细胞结合补体激活产品；2)SLE疾病活动性的测量；3)潜在的治疗调节剂和介质：基线疼痛和社会经济地位，自我效能感和感知压力。我们将评估干预措施后以及6个月和12个月随访时的健康结果。SLE是最复杂的自身免疫性疾病之一，也是抑郁症发病率最高的疾病之一。MBST干预在解决这一患者群体独特的身体表现和精神痛苦方面具有强大的潜力，并可能对患有其他衰弱性慢性疾病的痛苦患者产生广泛的影响。公共卫生相关性：抑郁症在慢性炎症性疾病患者中非常常见，包括系统性红斑狼疮（SLE）。我们将评估一种新的非药物干预的效果，心身技能训练（MBST），以改善SLE合并抑郁症患者的身心健康。SLE是最复杂和最具破坏性的自身免疫性疾病之一，如果MBST对SLE有益，那么这种干预可能对患有其他衰弱性慢性疾病的患者也有广泛的健康影响。

DESCRIPTION (provided by applicant): 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.