A meta-analysis of fibromyalgia treatment interventions

Rossy, Lynn A.; Buckelew, Susan P.; Dorr, Nancy; Hagglund, Kristofer J.; Thayer, Julian F.; McIntosh, Matthew J.; Hewett, John E.; Johnson, Jane C.

doi:10.1007/bf02908299

Cited by 354 publications

(226 citation statements)

References 48 publications

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“…Findings from several meta-analyses suggest that optimal care combines medication, exercise, and psychosocial intervention (20,24 -28), and broad improvements have been observed with treatment plans that include nonpharmacologic intervention (24,29,30).…”

Section: Introductionmentioning

confidence: 99%

Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial

Sephton¹,

Salmon²,

Weissbecker³

et al. 2007

Arthritis & Rheumatism

333

189

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Objective. Depressive symptoms are common among patients with fibromyalgia, and behavioral intervention has been recommended as a major treatment component for this illness. The objective of this study was to test the effects of the Mindfulness-Based Stress Reduction (MBSR) intervention on depressive symptoms in patients with fibromyalgia. Methods. This randomized controlled trial examined effects of the 8-week MBSR intervention on depressive symptoms in 91 women with fibromyalgia who were randomly assigned to treatment (n ‫؍‬ 51) or a waiting-list control group (n ‫؍‬ 40). Eligible patients were at least 18 years old, willing to participate in a weekly group, and able to provide physician verification of a fibromyalgia diagnosis. Of 166 eligible participants who responded to local television news publicizing, 49 did not appear for a scheduled intake, 24 enrolled but did not provide baseline data, and 2 were excluded due to severe mental illness, leaving 91 participants. The sample averaged 48 years of age and had 14.7 years of education. The typical participant was white, married, and employed. Patients randomly assigned to treatment received MBSR. Eight weekly 2.5-hour sessions were led by a licensed clinical psychologist with mindfulness training. Somatic and cognitive symptoms of depression were assessed using the Beck Depression Inventory administered at baseline, immediately postprogram, and at followup 2 months after the conclusion of the intervention. Results. Change in depressive symptoms was assessed using slopes analyses of intervention effects over time. Depressive symptoms improved significantly in treatment versus control participants over the 3 assessments. Conclusion. This meditation-based intervention alleviated depressive symptoms among patients with fibromyalgia.

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Section: Introductionmentioning

confidence: 99%

Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial

Sephton¹,

Salmon²,

Weissbecker³

et al. 2007

Arthritis & Rheumatism

333

189

View full text Add to dashboard Cite

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“…Furthermore, because the syndrome is characterized by multiple symptoms with no known organic basis, FM is difficult to treat (MacFarlane et al, 2001;Wolfe & Hawley, 1999). According to a meta-analysis conducted by Rossy et al (1999), the optimal treatment for FM consists of a combination of nonpharmacological treatments, such as exercise, education, and cognitive-behavioral therapy and medication management for sleep and pain symptoms. Although these treatments may be helpful in alleviating symptoms of FM, they are not always effective and there is variable resolution of symptoms.…”

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confidence: 99%

The role of illness uncertainty on coping with fibromyalgia symptoms.

2006

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Uncertainty is a common component of the illness experience and can increase the burden of managing chronic illness. The present study examined the role of illness uncertainty in pain coping among 51 women with Fibromyalgia (FM), a chronic pain condition of unknown origin. After completing demographic and illness uncertainty questionnaires, participants underwent 10 to 12 weekly interviews regarding pain, coping difficulty, and coping efficacy. Multilevel analyses indicated that pain elevations in the presence of illness uncertainty predicted increases in coping difficulty. Furthermore, when participants had more difficulty coping, they also had lower levels of coping efficacy. Results are consistent with a model where illness uncertainty accompanied by episodic pain negatively affects coping efficacy, an important resource in adaptation to FM. KeywordsIllness uncertainty; pain; coping difficulty; coping efficacy; fibromyalgia Uncertainty is a salient issue for many who have been diagnosed with life-threatening or chronic illnesses (Mast, 1995;Mishel, 1999), particularly for those whose illness itself has no known organic cause. One such prevalent condition is Fibromyalgia (FM). FM has been characterized by the presence of widespread and often unpredictable musculoskeletal pain, tenderness, fatigue, stiffness, and sleep disturbance. However, it has also been associated with numerous psychosocial conditions, such as depression, anxiety, and physical and sexual abuse (Wolfe & Hawley, 1999;Wolfe, Ross, Anderson, Russell, & Hebert, 1995). Not only do FM patients have a greater number of comorbid physical and psychological conditions than many other chronic pain conditions, but they also have more difficulty coping with their condition (Zautra, Hamilton & Burke, 1999). Furthermore, because the syndrome is characterized by multiple symptoms with no known organic basis, FM is difficult to treat (MacFarlane et al., 2001;Wolfe & Hawley, 1999). According to a meta-analysis conducted by Rossy et al. (1999), the optimal treatment for FM consists of a combination of nonpharmacological treatments, such as exercise, education, and cognitive-behavioral therapy and medication management for sleep and pain symptoms. Although these treatments may be helpful in alleviating symptoms of FM, they are not always effective and there is variable resolution of symptoms.To further our understanding of the difficulties in adjustment for FM patients, we sought to examine a variable that differentiates FM from other rheumatic diseases. Illness uncertainty has been found to be significantly higher in FM compared to OA patients (Reich, Olmsted, & Van Puymbroeck, in press sense of loss of control, and a perception about one's illness that changes over time (Mast, 1995, Weiner & Dodd, 1993. Mishel defines illness uncertainty as "the inability to determine the meaning of illness-related events (that) occurs in situations where the decision-maker is unable to assign definite values to objects and events and/or is unable to accurately predi...

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“…25 The ideal strategy will combine nonpharmacologic and pharmacologic treatments in a multimodal approach tailored to the individual patient. 31 Physicians are therefore …”

Section: What Is the Ideal Treatment Strategy?mentioning

confidence: 99%