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，经常 与重大的心理痛苦有关。建立在我们团队在狼疮生物医学方面的优势 研究和行为干预，我们建议研究一种非药物干预来改善 系统性红斑狼疮合并抑郁症患者的身心健康状况。 在这个名为《减少系统性红斑狼疮患者抑郁症状》的项目中，我们将研究安慰剂的疗效。 创新的非药物干预，心身技能训练(MBST)，以改善智力和 随机对照试验(RCT)中系统性红斑狼疮患者的身体健康结果。MBST是一种新的方法，它 结合认知-行为治疗方法、身心放松技巧和正念成分， 其中每一种都有利于减轻其他炎症情况下的疼痛和/或痛苦。我们将分配给 150例有抑郁障碍或亚综合征抑郁的SLE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届MBST的效果 关于1)精神健康(抑郁)和2)身体健康(疼痛、疲劳和与健康相关的质量)的计划 生活)。此外，我们还将探索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，在我们的网站上开发，2) 衡量SLE疾病活动性，我们将探索3)潜在的治疗修饰物和介体： 基线疼痛和社会经济地位，以及自我效能和感觉到的压力。我们将评估健康状况 干预后以及6个月和12个月随访的结果。 系统性红斑狼疮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 干预有很强的潜力来解决这种独特的身体表现和精神痛苦。 患者群体，并可能对患有其他衰弱慢性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.