CBTs provided a small incremental benefit over control interventions in reducing pain , negative mood and disability at the end of treatment and at long-term follow-up .
The dropout rates due to any reason did not differ between CBTs and controls
BACKGROUND Fibromyalgia ( FM ) is a clinical ly well-defined chronic condition of unknown aetiology characterized by chronic widespread pain that often co-exists with sleep disturbances , cognitive dysfunction and fatigue .
Patients often report high disability levels and negative mood .
Psychotherapies focus on reducing key symptoms , improving daily functioning , mood and sense of personal control over pain .
OBJECTIVES To assess the benefits and harms of cognitive behavioural therapies ( CBTs ) for treating FM at end of treatment and at long-term ( at least six months ) follow-up .
Cognitive behavior therapy, exercise, or both for treating chronic widespread pain.
BACKGROUND The clinical impact of telephone-delivered cognitive behavioral therapy ( TCBT ) , exercise , or a combined intervention in primary care patients with chronic widespread pain ( CWP ) is unclear . METHODS A total of 442 patients with CWP ( meeting the American College of Rheumatology criteria ) were r and omized to receive 6 months of TCBT , grade d exercise , combined intervention , or treatment as usual ( TAU ) . The primary outcome , using a 7-point patient global assessment scale of change in health since trial enrollment ( range : very much worse to very much better ) , was assessed at baseline and 6 months ( intervention end ) and 9 months after r and omization . A positive outcome was defined as " much better " or " very much better . " Data were analyzed using logistic regression according to the intention-to-treat principle . RESULTS The percentages reporting a positive outcome at 6 and 9 months , respectively , were TAU group , 8 % and 8 % ; TCBT group , 30 % and 33 % ; exercise group , 35 % and 24 % ; and combined intervention group , 37 % and 37 % ( P < .001 ) . After adjustment for age , sex , center , and baseline predictors of outcome , active interventions improved outcome compared with TAU : TCBT ( 6 months : odds ratio [ OR ] , 5.0 [ 95 % CI , 2.0 - 12.5 ] ; 9 months : OR , 5.4 [ 95 % CI , 2.3 - 12.8 ] ) , exercise ( 6 months : OR , 6.1 [ 95 % CI , 2.5 - 15.1 ] ; 9 months : OR , 3.6 [ 95 % CI , 1.5 - 8.5 ] ) , and combined intervention ( 6 months : OR , 7.1 [ 95 % CI , 2.9 - 17.2 ] ; 9 months : OR , 6.2 [ 95 % CI , 2.7 - 14.4 ] ) . At 6 and 9 months , combined intervention was associated with improvements in the 36-Item Short Form Health Question naire physical component score and a reduction in passive coping strategies . Conclusions on cost-effectiveness were sensitive to missing data . CONCLUSION TCBT was associated with substantial , statistically significant , and sustained improvements in patient global assessment . TRIAL REGISTRATION clinical trials.gov Identifier : IS RCT N67013851
CBTs provided a small incremental benefit over control interventions in reducing pain , negative mood and disability at the end of treatment and at long-term follow-up .
The dropout rates due to any reason did not differ between CBTs and controls
BACKGROUND Fibromyalgia ( FM ) is a clinical ly well-defined chronic condition of unknown aetiology characterized by chronic widespread pain that often co-exists with sleep disturbances , cognitive dysfunction and fatigue .
Patients often report high disability levels and negative mood .
Psychotherapies focus on reducing key symptoms , improving daily functioning , mood and sense of personal control over pain .
OBJECTIVES To assess the benefits and harms of cognitive behavioural therapies ( CBTs ) for treating FM at end of treatment and at long-term ( at least six months ) follow-up .