Effectiveness of cognitive-analytic therapy (CAT) in major depression and systemic lupus erythematosus: a case report

Background

A significant number of patients with systemic lupus erythematosus (SLE) suffer from depression. Most episodes of depression in SLE seem to be caused by non-organic factors i.e. patients' responses to the burden of disease and the social consequences of the disease. Therapeutic interventions should consist of a combined pharmacological and non-pharmacological treatment. Cognitive Analytic Psychotherapy (CAT) is a form of brief psychotherapy -its effectiveness has been showed in several studies with patients who manifested various psychological problems. The present study aims to present the appliance of CAT in a patient with SLE and depression.

Materials and methods

A 35-year-old married woman had a 12-years history of SLE. She attended a Community Mental Health Center (CMCH) in Thessaloniki (Greece) manifesting depressed mood, anhedonia, sleep disturbance, and difficulty in the interpersonal relationships. She received a diagnosis of Major Depressive Disorder (according to DSM-IV criteria) and CAT was applied in combination with antidepressant medication (10mg escitalopram/day).

Results

After a 16-sessions course of CAT, the patient showed significantly improvement. Furthermore, for first time during the last decade there was also an improvement in SLE laboratory screening tests i.e. CRP, C, C3, C4, which lead to a reduction of the corticosteroid pharmacotherapy. This improvement was well stabilized for -at least- the next six months.

Conclusions

It is of interest that a brief psychotherapy, i.e. CAT, could be effective both in reducing psychological distress and medical symptoms in SLE.