Online therapy aids the isolated, immunosuppressed in pandemic

People with a rare autoimmune disease, who likely experience more serious isolation during a global pandemic, saw their anxiety and depression improve after receiving online mental health intervention through an international study involving investigators from Michigan Medicine.

The paper, published in The Lancet Rheumatology, analyzed the mental health progress of over 150 people with scleroderma, a disease that causes tightening of the skin and connective tissues. Researchers randomized patients to either receive video support intervention or be put on a waitlist, finding mental health outcomes improved after the program finished.

"COVID-19 isolation has had a very serious impact, especially on these scleroderma patients who are immunocompromised and have a higher chance of dying if they catch it," said John Varga, M.D., a co-author of the study, chief of the Michigan Medicine Division of Rheumatology and associate director of the U-M Scleroderma Program. "This shows that virtual intervention can be very effective in mitigating these mental health issues in a cost-effective way across large cohorts of patients."

The Scleroderma Patient-centered Intervention Network designed a four-week program that offered group mental health intervention from trained peer support leaders three times each week. To ensure access, members of the waitlisted control group were still offered the SPIN therapy.

The intervention did not show improvements for the global cohort immediately following the program. However, anxiety and depression symptoms dropped significantly six weeks later, potentially revealing the time it took for new skills and social support to take effect.

While this intervention took place before the COVID-19 vaccine was widely available, the disease is a paradigm for public health issues that cause people increased anxiety, Varga said.

"If something else comes along where people with a chronic disease are vulnerable or anxious, you can intervene in a virtual way that has a measurable impact," he said. "This allows participants to be educated on staying connected, physical activity, and managing worry and stress. It sends a very positive message."