The Effectiveness of Cognitive-Behavioral Therapy on Pain Perception and Alexithymia in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial with a Three-Month Follow-Up

Abstract

Introduction: Rheumatoid Arthritis (RA) is a chronic systemic autoimmune disorder associated not only with debilitating physical symptoms like pain and joint destruction but also with a significant emotional burden. This study aimed to investigate the effectiveness of Cognitive-Behavioral Therapy (CBT) on two key components of this experience: pain perception and alexithymia, in patients with RA.

Methods: This quasi-experimental study employed a pre-test, post-test design with a control group and a three-month follow-up. From the statistical population of patients visiting rheumatology clinics in Isfahan in 2023, 30 eligible patients were selected via convenience sampling and randomly assigned to either an experimental group (n=15) or a control group (n=15). The experimental group received eight 90-minute group sessions of CBT, while the control group received only routine care during this period. Data collection tools included the Toronto Alexithymia Scale (TAS-20) and the Visual Analog Scale (VAS) for pain, completed at pre-test, post-test, and follow-up stages. Data were analyzed using Repeated Measures ANOVA in SPSS-26 software.

Results: Data analysis revealed a significant difference between the experimental and control groups regarding pain perception and alexithymia scores at post-test and follow-up stages. The CBT intervention led to a significant reduction in pain perception scores (p < 0.05) and alexithymia scores (p < 0.05) in the experimental group compared to the control group. These positive effects were maintained at the three-month follow-up assessment.

Conclusion: Based on the findings of this study, Cognitive-Behavioral Therapy, by targeting maladaptive cognitive and emotional patterns, can be utilized as an effective complementary intervention alongside standard pharmacological treatments to reduce pain suffering and improve emotion regulation in patients with Rheumatoid Arthritis. Integrating this intervention into comprehensive treatment protocols can contribute to enhancing the quality of life for these patients.