Effect of Dialectical Behavioral Therapy on quality of life, stress and related psychological variables in women with Hashimoto's disease: Randomized controlled trial

Literature shows that there are aspects of Hashimoto's disease (HD) where medical treatment can be limited. The aim of the present study, was to investigate the effect of Dialectical Behavioral Therapy Skills Training (DBT-ST), Group Cognitive Behavioral Therapy (CBT) and a waitlist group on quality of life (QOL), depression, anxiety, stress, psychological well-being, difficulties in emotion regulation, emotional reactivity, and distress tolerance among women diagnosed with HD. The study was conducted via randomized controlled experimental design, with interventions being applied simultaneously to an experimental, control and waitlist group, which were matched for age, QOL, disease duration, economic status, level of education, marital status, working status, and childhood trauma. The experimental group received a 14-week DBT-ST intervention, the control group received a 14-week Group CBT intervention, while the waitlist group received no intervention. Participants included 62 women (x̄=35.85±6.37 years) diagnosed with HD and whose medical treatment was stable. All were randomly assigned to the groups. Outcome variables were evaluated via scales, with data being collected pre-intervention, post-intervention and at two months follow-up. Results demonstrated that while Group CBT and the waitlist group had no statistically significant benefits on the outcome variables, DBT-ST increased the general health dimension of QOL, the environmental mastery subscale of psychological well-being, the persistence subscale of emotional reactivity and the tolerance subscale of distress tolerance, and decreased depression, anxiety, stress and difficulties in emotion regulation at statistically significant levels. Economic status was identified as a covariate for anxiety and stress, and body mass index for general health. With the effect of covariates considered, DBT-ST explained the decrease in stress by 10.1%, an additional 2.7% compared to economic status which explained it by 7.4% (p<.05). Findings demonstrate that DBT-ST, rather than Group CBT and the waitlist group, had beneficial effects on women with HD, specifically in terms of QOL and stress. Future research conducted in lieu with the recommendations of the present study, could further contribute to the development of HD treatment guidelines.