Psychological interventions for reducing depressive symptoms in rheumatoid arthritis patients: a systematic review and network meta-analysis.

Abstract

Depression has long been recognized as the most common mental disorders of rheumatoid arthritis (RA) patients. This study aimed to compare and rank the efficacy of different psychological interventions for reducing depressive symptoms among RA patients. The PubMed, Embase, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang databases, and grey literature were searched between inception and 1 June 2023. Pairs of reviewers screened studies, abstracted aggregate-level data, and appraised risk of bias with the Cochrane risk of bias tool. The study was conducted using the STATA software version 14.0. A total of 23 randomized controlled trials, involving 1885 participants and 16 interventions were included in our analyses. In this network meta-analysis, two interventions were associated with a greater reduction in symptoms of depression compared with treatment as usual care group: mindfulness-based cognitive therapy (MBCT) and combined psychological interventions (CP). Although most psychological interventions showed non-significant effects, the surface under the cumulative ranking curve (SUCRA) values revealed that the best psychological intervention for depression was MBCT (99.9%), followed by CP (85.6%). MBCT may be the most recommended intervention against the depression among RA patients according to our network meta-analysis results. Considering the methodological limitations of the included studies, more high-quality and large-sample RCTs are needed to confirm this result in the future.