Cognitive behavioural therapies for fibromyalgia

Area of Science:

• Rheumatology
• Psychiatry
• Clinical Psychology

Background:

• Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, sleep disturbances, and cognitive dysfunction.
• Patients often experience significant disability and negative mood, impacting their quality of life.
• Psychotherapies aim to alleviate key FM symptoms and improve patients' daily functioning and sense of control.

Purpose of the Study:

• To evaluate the efficacy and safety of cognitive behavioural therapies (CBTs) for fibromyalgia.
• To assess treatment benefits at the end of therapy and during long-term follow-up (at least six months).

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) involving children, adolescents, and adults with FM.
• Comprehensive literature search across major databases (CENTRAL, MEDLINE, PsycINFO, SCOPUS) and clinical trial registries.
• Independent data extraction and risk of bias assessment for all included studies.

Main Results:

• Twenty-three RCTs (2031 patients) were included; most had a high risk of bias, and overall evidence quality was low.
• CBTs demonstrated statistically significant, albeit small, improvements in reducing pain, negative mood, and disability compared to control groups.
• Benefits in pain reduction (0.5-0.6 points), mood (0.7-1.3 points), and disability (0.7-1.2 points) were observed at both end of treatment and long-term follow-up.
• No significant differences were found in dropout rates between CBT and control groups.

Conclusions:

• Cognitive behavioural therapies (CBTs) provide a small but incremental benefit for fibromyalgia patients in managing pain, mood, and disability.
• The positive effects of CBTs are sustained at long-term follow-up.
• CBTs are a viable treatment option with comparable dropout rates to other interventions.