Cognitive behavioral treatment of fibromyalgia syndrome: a followup assessment

In a previous study, we showed that cognitive behavioral therapy (CBT) was effective in the short term treatment of fibromyalgia (FMS). We tested the hypothesis that a pooled index of 10 target psychometric outcomes would show overall improved outcome at longterm followup versus pretreatment.

Using a quasiexperimental design and validated psychometric instruments, we compared pretreatment psychometric variables with longterm outcomes in the 25 subjects who had completed the earlier study. A distinction was made between target variables the program had specifically addressed and nontarget variables not specifically addressed.

Twenty-two subjects participated at a mean of 30 months after discharge from the program. As at short term followup, no nontarget variable changed from pretreatment to longterm assessment. The short term improvement that had been observed in all 10 target variables was maintained in 3 variables at a Bonferroni corrected alpha level of 0.005: worry, p < 0.001; observed pain behavior, p < 0.001; and control over pain, p < 0.002. All 10 target variables changed in the direction of improvement. A pooled index of these 10 variables showed statistically significant improvement from baseline (p < 0.002).

Our results suggest that CBT may have a role in the longterm treatment of FMS.