Cognitive behavioural group therapy to improve patients’ strategies for coping with restless legs syndrome: a proof-of-concept trial
- M Hornyak1,2,
- C Grossmann1,
- R Kohnen3,
- M Schlatterer1,
- H Richter1,
- U Voderholzer1,
- D Riemann1,
- M Berger1
- 1Department of Psychiatry and Psychotherapy, University Medical Centre, Freiburg, Germany
- 2Interdisciplinary Pain Centre, University Medical Centre, Freiburg, Germany
- 3IMEREM, Nuremberg, and Department of Psychology, University Erlangen-Nuremberg, Germany
- Dr M Hornyak, Interdisciplinary Pain Centre and Department of Psychiatry and Psychotherapy, University Medical Centre, Breisacher Strasse 64, D-79106 Freiburg, Germany;
- Received 5 November 2007
- Revised 1 February 2008
- Accepted 7 February 2008
- Published Online First 26 February 2008
Background: 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 the coping strategies and quality of life of RLS sufferers.
Objective: To develop cognitive behavioural therapy tailored to this disorder (the RELEGS coping therapy programme) and present the results of this proof-of-concept study.
Methods: Twenty-five patients (five men, 20 women; 15 medicated, 10 unmedicated; mean (SD) age 56.1 (12.3) years) with subjective psychosocial impairment due to RLS participated in one of three consecutive therapy groups. 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. Each group took part in eight group sessions (90 min each with a break).
Results: At the end of the treatment, both the RLS-related quality of life and the mental health status of the subjects had improved significantly (QoL-RLS scale: from 28.6 (12.8) to 23.4 (13.1); SCL-90-R: from 51.3 (37.0) to 45.9 (32.9)). The improvement remained at follow-up 3 months later. Subjective ratings of RLS severity had improved at the end of therapy and at follow-up. Psychometric scales not specific for RLS-related impairment remained unaffected by the treatment.
Conclusions: The study establishes the feasibility and high acceptance of the newly devised therapy programme. The application of RLS-oriented specific psychological strategies is a step toward an integrated treatment approach in RLS.
An addendum is published online only at http://jnnp.bmj.com/content/vol79/issue7
Funding: Unrestricted grant from the German RLS Patient Support Group, RLS e.V., Munich, Germany.
Competing interests: None.
Ethics approval: Ethics approval was obtained.
Patient consent: Informed consent was obtained for publication of the case details described in this report.