Cognitive behavioral group therapy to improve patients 
coping strategies
with restless legs syndrome: A proof-of-concept trial
Magdolna Hornyak 1*, Claudia Grossmann 1, Ralf Kohnen 2, Martina Schlatterer 1, Harald Richter 1, Ulrich Voderholzer 1, Dieter Riemann 1 and Mathias Berger 1
1 University Medical Center Freiburg, Germany, Germany
2 IMEREM Research GmbH, Germany
* To whom correspondence should be addressed. E-mail: magdolna.hornyak{at}uniklinik-freiburg.de.
Accepted 7 February 2008
 | Abstract |
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Objective: Restless Legs Syndrome (RLS) is a usually chronic disorder accompanied by clinically relevant psychosocial impairment. To date, no psychologically-based approach is available to improve RLS sufferers¡¦ coping strategies and quality of life. We developed a cognitive behavioral therapy tai-lored especially for this disorder (the RELEGS coping therapy program) and present the results of this proof-of-concept study.
Methods: Twenty-five patients with subjective psychosocial impairment due to RLS participated in one of 3 consecutive therapy groups (5 males, 20 females; 15 medicated, 10 unmedicated, age: 56.1 "b 12.3 yrs). The severity scales (IRLS and RLS-6) indicated moderate to severe RLS symptoms at baseline. Exclusion criteria were secondary RLS, foreseeable change of RLS medication during the study period, serious physical or psychiatric comorbidity, and severe cognitive deficits. Eight group sessions (90 min with a break) for each group took place.
Results: At the end of the treatment, both the RLS-related quality of life and the mental health status of the subjects improved significantly (QoL-RLS scale: p < 0.001; SCL-90-R, p = 0.031). The im-provement remained stable at follow-up 3 months later. Subjective ratings of RLS severity improved at the end of therapy and at follow-up either. Psychometric scales not specific for RLS-related impair-ment remained unaffected by the treatment.
Conclusions: The study establishes the feasibility and the high acceptance of the newly devised therapy program. The application of RLS-oriented specific psychological strategies provides a step toward an integrated treatment approach in RLS.
