While several studies in RA patients revealed a long-term efficacious role of CBT interventions in pain behavior, disease activity, joint stiffness, anxiety and depression, others did not confirm the positive effects on disease activity or joint counts, though they did maintain positive outcomes on anxiety, depression, fatigue, and pain management (10); inhibition of IL-6 production seems to mediate the observed positive effects (59). This evidence concerns the gene IL6 and rheumatoid arthritis.