P060 Pilot study showing the efficacy and acceptability of an acceptance and commitment therapy based brief psychological intervention on mood and disability in patients with early inflammatory arthritis

Abstract Background/Aims Psychiatric comorbidities are common in patients living with rheumatological conditions and are associated with poorer health outcomes and treatment response. The evidence base for psychological intervention is scarce and of poor quality. One trial has found CBT intervention early post-diagnosis of rheumatoid arthritis has small to medium effect sizes for depression and anxiety and no effect on disability. Acceptance and Commitment Therapy (ACT) is a psychological therapy with a good evidence base for a number of long term health conditions. The target process in ACT is psychological flexibility, which relates closely to a number of positive life outcomes including adaptive response to illness and trauma. Psychological inflexibility has been shown to be associated with poorer function and psychological wellbeing in chronic pain populations and more recently juvenile idiopathic arthritis specifically. We aimed to evaluate outcomes for a sample (n = 12) of newly diagnosed (within 3 years of diagnosis) patients with inflammatory arthritis who underwent an individualised ACT intervention using patient satisfaction data, qualitative feedback and measures of mood, quality of life and psychological flexibility. Methods Patients received up to 7 sessions of one to one therapy. Outcome measures included PHQ-9, GAD-7, compACT, and Brief Pain Inventory (BPI) and a satisfaction questionnaire with open questions inviting qualitative responses. Paired t-tests were conducted, and the Jacobson and Truax method used to calculate Reliable Change Index and Clinically Significant Change criteria. Effect sizes were calculated using Cohens’ d. Correlation analysis was conducted using Pearsons correlation coefficients. Results Patients who took part in the brief intervention showed significant improvement in depression, anxiety, quality of life and psychological flexibility. Effect sizes were large. Correlation analysis showed strong correlations between PF and both depression and quality of life. Changes in PF from baseline to end of therapy strongly correlated with changes in depression and disability, and moderately correlated with anxiety. Subanalyses will be presented to understand which particular components of PF most closely relate to improvements in outcomes on disability and mood. Conclusion A brief one to one ACT-based psychological intervention conferred good benefit for a rheumatology population. Results suggest PF is a key therapeutic t