Abstract:Objective: Research into and the clinical use of mindfulness as a therapeutic intervention have increased in recent years and the results have been promising in a range of illness populations. One area in which mindfulness has been trialled is fibromyalgia, a chronic pain condition currently with poor treatment outcomes. The aim of this systematic review was to examine the effectiveness of mindfulness-based interventions on physical symptoms and psychological distress in patients with fibromyalgia. Methods: Systematic review: PubMed, PsycINFO, Embase and Scopus were searched for randomised controlled trials and prospective and retrospective studies. A quality assessment and synthesis of the quantitative data (based on guidelines from the Joanna Briggs Institute) was completed on studies using a mindfulness-based intervention with patients with fibromyalgia on outcomes related to physical symptoms and psychological distress and wellbeing. Results: Ten studies met the inclusion criteria. All included studies used a mindfulness-based group program design. Although outcome measures and data presentation varied, making statistical pooling impossible, the narrative synthesis resulted in overall positive evidence for the efficacy of mindfulness-based interventions for patients with fibromyalgia on a range of physical symptom and psychological distress outcome measures. Conclusion: Mindfulness is a favourable treatment option for patients with fibromyalgia. Whilst demonstrated efficacy was generally positive, the number of studies addressing this topic is small and there was wide variation in outcome measures and data presentation. More research is needed, particularly large-scale randomised controlled trials with consistent methodology, outcome measures and sufficient follow-up time periods.

Objectives Fibromyalgia is a chronic condition characterised by widespread musculoskeletal pain, fatigue, mood disturbances, and cognitive difficulties. Psychological flexibility (PF), particularly acceptance of pain, has been associated with the physical and psychological functioning (functional status) of chronic pain patients. Further investigation is required to assess the unique contribution of PF model components to functional status in people with fibromyalgia. This study investigated the role of both pain‐related PF and general acceptance of psychological experiences in a fibromyalgia sample after accounting for self‐efficacy beliefs, the use of traditional pain management strategies, and demographic variables. Methods Participants with fibromyalgia (n = 339; 95% female) were recruited primarily from fibromyalgia social media‐based support groups and support services. Participants completed an online questionnaire measuring PF components, self‐efficacy, traditional pain management strategies, and functional status. Results Pain‐related PF, general psychological acceptance, and self‐efficacy were significantly related to functional status, with higher levels of these variables associated with higher functioning. Use of traditional pain management strategies was not significantly related to functional status. Hierarchical multiple regression analysis demonstrated pain‐related PF explained a statistically significant but small (2%) amount of variance in functional status over and above self‐efficacy, traditional pain management strategies, and demographic variables. General psychological acceptance explained a further significant 2% of unique variance in functional status. Conclusions Pain‐related PF and general psychological acceptance added benefit to functioning of individuals with fibromyalgia. Nevertheless, this additional benefit was small, suggesting other psychological variables such as self‐efficacy may be more clinically relevant to functioning with fibromyalgia.