Cognitive Behavioral Therapy for Youth With Childhood-Onset Lupus: A Randomized Clinical Trial

Area of Science:

• Pediatric Rheumatology
• Childhood-onset Systemic Lupus Erythematosus (cSLE)
• Mental Health Interventions

Background:

• Childhood-onset lupus (cSLE) frequently co-occurs with depressive, fatigue, and pain symptoms.
• Existing treatments may not fully address the psychological and symptomatic burden in youth with cSLE.
• Remote delivery of interventions offers potential for increased accessibility.

Purpose of the Study:

• To assess the feasibility and acceptability of a remotely delivered cognitive behavioral intervention (TEACH) for youth with cSLE.
• To evaluate the impact of TEACH on depressive, fatigue, and pain symptoms compared to standard medical care.

Main Methods:

• A pilot randomized controlled trial involving adolescents and young adults (12-22 years) with cSLE.
• Participants were recruited from six pediatric rheumatology centers in the US and Canada.
• Randomization to either TEACH plus usual medical care or usual medical care alone, with assessments at baseline and eight weeks.

Main Results:

• Recruitment rate was 48.5% (97/200 approached), with high retention (92.2%) among 64 eligible participants.
• The TEACH group showed significant reductions in depressive symptoms (14%) and fatigue (7%).
• No significant reduction in pain symptoms was observed in the intervention group compared to usual care.

Conclusions:

• Remotely delivered TEACH is a feasible and acceptable intervention for youth with cSLE.
• TEACH effectively reduced depressive and fatigue symptoms in this population.
• Implementing TEACH within medical settings could enhance accessibility and improve patient outcomes.