Supplementary Material for: A Tale of two Treatments: A randomized controlled trial of mindfulness or cognitive-behaviour therapy delivered online for people with rheumatoid arthritis

Introduction: This study aims to determine the relative efficacy of mindfulness-based stress reduction (MBSR) or cognitive-behaviour therapy (CBT) in comparison to a wait-list control (WLC) for people with rheumatoid arthritis (RA). Participants completed assessments before and after treatment and at 6-month follow-up.
Methods: Two-hundred and sixty-nine participants with RA were recruited and randomized in a 2:2:1 ratio to MBSR: CBT: WLC. Participants completed a semi-structured clinical interview for depression and were stratified for history of recurrent depression. We measured the primary outcome of pain interference, and pain severity, depression, anxiety, functional ability, and fear of progression. We predicted that MBSR and CBT would result in improvements compared to WLC . We also predicted that those with a history of recurrent depression would benefit more from MBSR than CBT for depression.
Results: MBSR and CBT were equally efficacious in reducing pain interference compared to WLC. Similar results were found for depression. MBSR demonstrated superior outcomes to CBT for fear of progression at post-treatment and functional ability at 6-month follow-up. CBT only was better than WLC for pain severity at 6-month follow-up. Depressive status did not moderate the efficacy of treatment.
Conclusions: MBSR and CBT resulted in statistically and clinically significant changes in pain interference compared to WLC. MBSR was more efficacious than CBT for functional ability and fear of progression, while CBT showed superiority for pain severity. The effect sizes were comparable to those achieved with face-to-face interventions, confirming both online treatments are effective for people with RA.

引言：本研究旨在确定正念减压疗法（MBSR）或认知行为疗法（CBT）与等待名单控制（WLC）在类风湿关节炎（RA）患者中的相对疗效。参与者于治疗前后及6个月随访时完成评估。研究方法：招募了269名RA患者，按照2:2:1的比例随机分配至MBSR：CBT：WLC组。参与者完成了一项关于抑郁症的半结构化临床访谈，并根据复发性抑郁症病史进行分层。我们测量了主要结局指标——疼痛干扰、疼痛程度、抑郁、焦虑、功能能力和疾病进展恐惧。我们预测MBSR和CBT与WLC相比将导致改善。我们还预测，有复发性抑郁症病史的患者将从MBSR中获得比CBT更大的益处。结果：MBSR和CBT在减少疼痛干扰方面与WLC同样有效。对于抑郁症状，也观察到了相似的结果。在治疗结束后和6个月随访时，MBSR在疾病进展恐惧和功能能力方面表现出优于CBT的效果。在6个月随访时，仅CBT在疼痛程度方面优于WLC。抑郁状态并未调节治疗的疗效。结论：MBSR和CBT与WLC相比，在疼痛干扰方面产生了统计学和临床意义上的显著变化。MBSR在功能能力和疾病进展恐惧方面比CBT更有效，而CBT在疼痛程度方面显示出优势。效应量与面对面干预达到的效应量相当，证实了这两种在线治疗对于RA患者都是有效的。