medwireNews: A videoconference-based group intervention aimed at reducing anxiety and other mental health symptoms in people with systemic sclerosis does not show immediate benefits but may have a delayed impact, study findings indicate.
Brett Thombs (McGill University, Montreal, Quebec, Canada) and colleagues suggest that the lag in benefit could reflect “the time it took for new skills and social support between intervention participants to affect mental health.”
The study included 172 participants with systemic sclerosis (mean age 55 years, 94% women, 79% White) and at least mild anxiety symptoms, who had not tested positive for COVID-19, and were not currently receiving mental health counselling.
Of these, 86 were randomly assigned to participate in the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Program, which involved taking part in three 90-minute videoconferencing sessions per week for 4 weeks.
The sessions, facilitated by people with systemic sclerosis or patient organization staff members, each included six to 10 participants and involved elements recommended by the WHO and other major public health organizations to support mental health during COVID-19, such as maintaining a daily routine, healthy information consumption, staying connected with others, physical activity, and simple anxiety-management strategies.
The researchers report in The Lancet Rheumatology that anxiety symptoms after the last intervention session, as measured by the PROMIS Anxiety 4a version 1.0 questionnaire, improved to a similar degree from baseline in the intervention participants and in the 86 participants who were randomly assigned to the waitlist control group (mean difference 1.57 points).
However, at 6 weeks post-intervention, anxiety scores were a significant 2.36 points lower in the intervention group than in the control group and intervention participants were significantly more likely to report an improvement in anxiety that exceeded the 4.0-point threshold for clinical significance, at 67% versus 51%.
Thombs and team also found that depression symptoms (Patient Health Questionnaire-8) were a significant 1.64 points lower at 6 weeks post-intervention in the intervention versus control groups, but there was no difference immediately after participation.
There were no significant differences between the two groups, however, at either timepoint in physical activity, loneliness, boredom, or COVID-19 fear.
The investigators note that at approximately 2 months after the end of the trial, nine of 11 group facilitators said that their group continued to meet regularly.
The authors conclude that although the immediate effectiveness of intervention remains unclear, the delayed reduction in anxiety and depression symptoms “might reflect the time needed to make behavioural changes or the ongoing social support that participants continued to provide to each other post-intervention, but this should be investigated in future studies.”
In an accompanying comment, Jill Newby, from the University of New South Wales in Sydney, Australia, says the study “highlights how essential it is to test, rather than assume what interventions work to improve mental health in susceptible groups during pandemic situations.”
She adds that “the SPIN-CHAT Program led to small positive improvements in anxiety, which has the potential to improve the quality of life of patients with scleroderma during a particularly anxiety-provoking time. However, more research is needed to improve the efficacy of the programme and test it in more diverse groups, before widespread roll-out.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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