جستجوی مقالات مرتبط با کلیدواژه « fibromyalgia » در نشریات گروه « پزشکی »

Cognitive-behavioral therapy (CBT) is acknowledged as an efficient therapeutic modality in fibromyalgia. However, its effect on the oxidative balance of fibromyalgia patients has not been investigated.

We investigated whether CBT intervention could influence serum markers of oxidative balance.

Forty fibromyalgia patients were randomly assigned to either the intervention (CBT) or control (waiting list) group. For the intervention group, traditional face-to-face CBT was performed for 20 sessions over two months. Sixteen patients in the CBT group and 17 patients in the control group completed the study. Outcomes were the serum total oxidant status (TOS) and total antioxidant capacity (TAC) that were assessed before the intervention and at the end of the intervention by an oxidation-reduction colorimetric assay. Within-group and between-group analyses were performed using theWilcoxon signed-rank test and Mann–Whitney U test, respectively.

Baseline characteristics showed no significant difference between the participants of the two groups. At the end of the study, mean TOS significantly reduced in the case group (P < 0.001) but not in the control group (P = 0.61), and mean TAC showed no significant change in the case and control groups (P = 0.1 and P = 0.09, respectively). The mean change in TOS was 0.43 ± 0.3 mM in the CBT group and 0.03 ± 0.2 mM in the control group (P < 0.001). The mean change in TAC was 0.015 ± 0.03 mM in the CBT group and 0.01 ± 0.02 mM in the control group (P = 0.57).

Cognitive-behavioral therapy improves the oxidative balance of fibromyalgia patients. Our results further support the benefits of CBT implication in the treatment of fibromyalgia.

Context: 

Neuroticism is associated with a heightened experience of bodily sensations and pain. This suggests that psychosocial factors can affect biological mechanisms. However, it is unclear whether fibromyalgia (FM) is associated with neuroticism and how these factors may be related.

 This study attempted to incorporate recent studies on fibromyalgia and neuroticism to comprehensively explain it.

 In this systematic review and meta-analysis based on the PRISMA guidelines (2020), PubMed, Psych INFO, Social Sciences, Scopus, ProQuest, and Google Scholar were searched for quantitative studies published up to August 31, 2022.

 Nineteen cross-sectional studies met the meta-analytic inclusion criteria, totaling 7,881 participants. The meta-analysis demonstrated high levels of neuroticism in fibromyalgia patients compared with control groups (Hedges’ g = 0.78; 95% CI = 0.54 − 1.02; P < 0.001). This meta-analysis provides evidence of the role of neuroticism as a contributing factor in the development and manifestation of fibromyalgia. Meta-regression and subgroup analyses were also conducted to investigate the potential moderators that might have influenced the effect size. The results of the meta-regression and subgroup analyses revealed that the health condition of the control group and the sex of the participants were significant moderators affecting the effect size.

 The results suggest that neuroticism should be specifically assessed and targeted in fibromyalgia interventions, especially in women. Furthermore, there should be particular emphasis on the mechanisms through which neuroticism may contribute to an increased risk of persistent pain and somatic complaints. As a result, fibromyalgia patients with high neuroticism levels should receive multimodal interventions to address neuroticism.

Chronic pain is considered as pain lasting for more than three months and has emerged as a global health problem affecting individuals and society. Chronic extensive pain is the main syndrome upsetting individuals with fibromyalgia (FM), accompanied by anxiety, obesity, sleep disturbances, and depression, Transient receptor potential vanilloid 1 (TRPV1) has been reported to transduce inflammatory and pain signals to the brain.

Acupoint catgut embedding (ACE) is a novel acupuncture technique that provides continuous effects and convenience. ACE was performed at the bilateral ST36 acupoint. 

We demonstrated similar pain levels among all groups at baseline. After cold stress, chronic mechanical or thermal nociception was induced (D14: mechanical: 1.85 ± 0.13 g; thermal: 4.85 ± 0.26 s) and reversed in ACE-treated mice (D14: mechanical: 3.99 ± 0.16 g; thermal: 7.42 ± 0.45 s) as well as Trpv1-/- group (Day 14, mechanical: 4.25 ± 0.2 g; thermal: 7.91 ± 0.21 s) mice. Inflammatory mediators were augmented in FM individuals and were abridged after ACE management and TRPV1 gene loss. TRPV1 and its linked mediators were increased in the thalamus (THA), somatosensory cortex (SSC), medial prefrontal cortex (mPFC), and anterior cingulate cortex (ACC) in FM mice. The up-regulation of these mediators was diminished in ACE and Trpv1-/- groups. 

We suggest that chronic pain can be modulated by ACE or Trpv1-/-. ACE-induced analgesia via TRPV1 signaling pathways may be beneficial targets for FM treatment.

The presence of sudden-onset fibromyalgia (FM) is poorly understood, characterized, and appreciated in both previous literature and the clinical setting. In this case series, we present 10 cases of sudden-onset FM seen in a community-based pain clinic, to characterize the presentation of this condition, stemming from both external trauma and idiopathic etiology.

This retrospective case series identified 10 patients diagnosed with FM attending the pain clinic. These patients were referred to chronic pain management clinic in Thunder Bay, Ontario, Canada, from January 2019 until December 2021 and met the diagnostic criteria for FM. Information was collected on sex, gender, age, details of signs and symptoms, and FM severity score as well as clinical findings and outcomes.

The case series identified 10 community residents (9 women and 1 man, F/M: 9/1, age range: 34-64 years, mean age: 51.7 years), with symptoms attributed to FM. Majority of patients suffered from total body pain and mental disorders such as depression. 60% of patients were on opioids at the time of referral. Combination of pharmacological and non-pharmacological management improved their pain symptoms within 3-6 months on follow-up.

Overall, effectively identifying sudden-onset FM can help clinicians improve patient-oriented outcomes and avoid the use of unnecessary narcotics in addition to better treating their patients.

In addition to pervasive pain, patients with fibromyalgia also complain about impaired cognitive functions, anxiety, and depression.

This study was conducted with the aim of comparing the effectiveness of mindfulness-based stress reduction (MBSR) and intensive short-term dynamic psychotherapy (ISTDP) in depression and the severity of symptoms in patients with fibromyalgia.

This was an experimental study with a pretest-posttest design and a control group with a 3-month follow-up. The statistical population covered all female patients with fibromyalgia visiting the Rheumatology Clinic of Rasool Akram Hospital in Tehran, Iran. Basedoninclusion criteriaandtheconvenience samplingmethod, 36 individualswereselectedandrandomlyassigned to 3 groups (2 experimental groups and a control group). Each experimental group received treatment (i.e., MBSR, eight 120-minute sessions, or ISTDP, eight 120-minute sessions). The research instruments included the Beck Depression Inventory-Second Edition and the Combined Index of Severity of Fibromyalgia. The results were analyzed using repeated measures analysis of variance (ANOVA).

The results showed that both interventions, namely MBSR and ISTDP, effectively reduced depression and the severity of symptoms in patients with fibromyalgia (P < 0.001). Mindfulness-based stress reduction and ISTDP were also significantly different in terms of effectiveness, with ISTDP being more effective with a longer-term follow-up effect (P < 0.001).

Mindfulness-based stress reduction and ISTDP were effective and practical methods for reducing depression and the severity of fibromyalgia symptoms. It is recommended that psychotherapists and counselors adopt these approaches to reduce depression and the severity of fibromyalgia symptoms in patients and help improve and reduce their symptoms.

Fibromyalgia Syndrome (FMS) is a widespread chronic musculoskeletal pain disorder. Although many treatments are available for fibromyalgia, management remains a challenge. Recent evidence suggests that personality traits may influence fibromyalgia.

According to PRISMA guidelines, this systematic review and meta-analysis explored harm avoidance and self-directedness in fibromyalgia patients using Cloninger's personality model. The meta-analysis included 14 studies evaluating harm avoidance and 11 studies evaluating self-directedness in patients with fibromyalgia compared with healthy individuals. Reported data from primary studies were pooled in a random-effects model using the Hedges' g approach. 

Fibromyalgia patients demonstrated high harm avoidance (Hedges' g= 1.31; 95% CI: 0.97 to 1.65) and low self-directedness (Hedges' g= -0.71; 95% CI: -1.00 to -0.42) comparing to healthy individuals. Additionally, the results showed that high harm avoidance was significantly related to an increased risk of FMS, although high self-directedness played a protective role against it.

The results demonstrated that high harm avoidance and low self-directedness are distinct personality traits in patients with fibromyalgia. Early identification and evaluation of a profile of high harm avoidance and low self-directedness may help conceptualize the underlying complex mechanisms of fibromyalgia. Additionally, it could identify patients who are more prone to entering a vicious cycle of disability and pain. Further research is required to understand the role of personality characteristics better.

Patients with Fibromyalgia, in addition to widespread pain, often complain of fatigue, sleep disorders, cognitive impairment, anxiety, and depression. The present study aimed to investigate the effectiveness of mindfulness-based stress reduction and intensive short-term dynamic psychotherapy on intolerance of uncertainty and depression in women with Fibromyalgia. This was a quasi-experimental study with a pretest-posttest control design and a three-month follow-up. The study population included all women with Fibromyalgia visiting the rheumatology clinic at Hazrat-e Rasool-e Akram Hospital, in Tehran, Iran, in 2021. A total of 36 patients were recruited using purposive sampling and assigned to three groups, two experimental groups and one control group (n=12 patients in each group). The experimental groups 1 and 2 received mindfulnessbased stress reduction therapy and intensive short-term dynamic psychotherapy, respectively, in eight 120-minute sessions (one session every week). Meanwhile, the control group did not receive psychotherapy intervention during this period. The Intolerance of Uncertainty Scale and the Beck Depression Inventory were used for data collection. The repeated measures ANOVA were used for analyzing the data in SPSS version 25. The significance level of the research was set at α=0.05. The results indicated that both mindfulness-based stress reduction therapy and intensive short-term dynamic psychotherapy effectively reduced intolerance of uncertainty and depression in Fibromyalgia patients (P<0.001). However, intensive short-term dynamic psychotherapy proved to be significantly more effective than mindfulness-based stress reduction therapy; this difference was observed through the follow-up period (P<0.001). Mindfulness-based stress reduction and intensive short-term dynamic psychotherapy were effective and practical methods for reducing intolerance of uncertainty and depression. It could be therefore recommended that psychotherapists and counselors employ these approaches in order to reduce depression and intolerance of uncertainty in women with Fibromyalgia.

The pain and disability caused by chronic diseases such as fibromyalgia disrupt physical, mental, and social activities and job performance. These factors, in turn, diminish mental health in such patients. The present study aimed to investigate the effectiveness of Mindfulness-Based Stress Reduction (MBSR) and Intensive Short-Term Dynamic Psychotherapy (ISTDP) in improving mental health and mitigating alexithymia in fibromyalgia patients.

Method and Materials: 

This quasi-experimental research adopted a pretest-posttest design with a control group and a three-month follow-up. The statistical population consisted of all females with fibromyalgia in the rheumatology clinic of Rasoul Akram Hospital in Tehran, Iran. Thirty-six of them were selected via convenience sampling based on inclusion criteria. The participants were randomly divided into a control group and two experimental groups, one receiving eight 120-min MBSR sessions and the other one receiving eight 120-min ISTDP sessions. The research instruments included the Mental Health Inventory (MHI) and the Toronto Alexithymia Scale (TAS-20). The data were analyzed via repeated measures ANOVA.

It was found that MBSR and ISTDP interventions were effective in mitigating alexithymia and improving mental health in fibromyalgia patients (P<0.001). There was a significant difference between MBSR and ISTDP, which ISTDP having higher effectiveness and more extended durability in the follow-up stage (P<0.05).

The MBSR and ISTDP interventions effectively mitigate alexithymia and improve mental health in fibromyalgia patients. Therefore, it is suggested that clinical psychologists use such interventions to improve the Quality of Life (QoL) for patients with fibromyalgia

Background: 

Mindfulness-Based Cognitive Therapy (MBCT) is a short-term and structured intervention approach that has a favorable research background. The aim of this study was to evaluate the effectiveness of MBCT on negative automatic thought, psychological symptoms, severity of pain and quality of life in female patients with fibromyalgia. 

Methods:

 In a randomized controlled trial, from February to October 2021, 20 patients with fibromyalgia were selected using purposive sampling method and assigned into two experimental and control groups through block randomization. MBCT was presented to the participants in the experimental group in eight sessions and the control group was placed on a waiting list. Quality of Life Questionnaire (WHOQOL-BREF), Pain Intensity Questionnaire (PIS), Psychological Symptoms Questionnaire (anxiety, stress and depression) (DASS), and Automatic Negative Thoughts Questionnaire (QNS) were completed by the participants in two stages (pre-test and post-test). Data were analyzed using multivariate analysis of covariance in SPSS version 26. 

Results:

 Preliminary results showed that MBCT had a significant effect on the severity of pain index and psychological symptoms (all’s <0.05). Secondary results also indicated that this therapeutic intervention was effective in reducing negative automatic thought and improving the quality of life (all’s<0.05). 

Conclusion: 

Findings of this study in line with the research background showed the effectiveness of this therapeutic approach on psychological indices in female patients with fibromyalgia, although additional studies in this field are suggested.

Fibromyalgia disease has a considerable effect on anxiety disorders such as subjective well-being. The present study aimed to investigate the effect of positive mindfulness therapy (PMT) and emotion-focused cognitive-behavioral therapy (EFCBT) in fibromyalgia patients’ response to stress and subjective well-being.

The research method was quasi-experimental with a pre-test and post-test design, and a control group. The statistical population included 160 women with fibromyalgia, visiting Red Cross affiliated physiotherapy clinics in Tehran in 2020. The sample consisted of 60 patients with fibromyalgia selected by convenience sampling and randomly divided into two experimental groups (PMT and EFCBT) and a control group (n= 20 per group). Data were collected using the Self-Regulation Inventory (SRI) and the Subjective Well-Being Scale. The validity and reliability of the research instruments were confirmed. Data were analyzed at descriptive and inferential levels using SPSS software version 20.

The results showed that the PMT produced significant improvements in subjective well-being and response to stress (P = 0.001) in patients with fibromyalgia. Furthermore, EFCBT was effective in improving subjective well-being and response to stress (P = 0.001) in the patients compared to the control group. The results did not imply a significant difference between the two treatment interventions.

PMT and EFCBT were effective in reducing response to stress and improving subjective well-being in patients with fibromyalgia. Based on the results, holding PMT and EFCBT workshops may exert beneficial effects on reducing response to stress and increasing subjective well-being in patients with fibromyalgia. According to the results, using positive mindfulness therapy and emotion-focused cognitive-behavioral therapy was effective in reducing response to stress and improving subjective well-being in patients with fibromyalgia

Fibromyalgia is recognized as a chronic pain syndrome. Widespread pain is a common symptom in fibromyalgia, indicating a potential dysfunction in the processing of painful sensations in the central nervous system.

This study aimed to investigate changes in the severity of clinical symptoms in fibromyalgia patients and to evaluate the apparent diffusion coefficients and metabolites in the brain of these patients.

 

This cross-sectional study included 28 female outpatients with complaints of widespread pain, who were diagnosed with fibromyalgia syndrome. Magnetic resonance imaging, magnetic resonance spectroscopy, and diffusion tensor examinations were applied to evaluate patients diagnosed with fibromyalgia before treatment.

The mean age of the patients included in this study was 39.1 ± 8.6 years (range, 24 - 55 years). A statistically significant strong positive correlation was found between the scores of the visual analog scale and the fibromyalgia impact questionnaire. Besides, significant associations were found between the scores of the visual analog scale and fibromyalgia impact questionnaire and the results of fractional anisotropy, apparent diffusion coefficient, and peak values of some metabolites in spectroscopy.

The results of this study suggest that metabolites play an inhibitory or excitatory role in the central pain mechanisms of fibromyalgia as a chronic pain syndrome.

Laser acupuncture (LA) is a medically approved treatment for chronic pain, especially fibromyalgia. It is widely known that all pain is related to autonomic modulation, which may influence heart rate variability (HRV). There are robust studies in the literature on the effect of LA with continuous frequency on musculoskeletal pain and autonomic modulation. However, little is known about the effect of pulsed frequency on fibromyalgia. Therefore, this study aimed to evaluate whether an individualized intervention protocol applying pulsed LA would provide benefits related to pain symptoms and cardiac autonomic modulation in patients with fibromyalgia.

In this pilot randomized clinical controlled trial, the sample consisted of women with fibromyalgia between the ages of 40 and 80, randomized into two groups: a control group (CG; n = 10) and an experimental group (EG; n = 10). EG received the intervention twice per week for 3 weeks. Statistical analysis was conducted by delta (difference between post-intervention and pre-intervention) and the Shapiro-Wilk test (normality). For comparison between the groups, the Mann-Whitney test was used.

The results showed a significant reduction in pain intensity as reported via the pain numerical scale (PNS; P = 0.00), generalized pain index (GPI; P = 0.00), and symptom severity scale (SSS; P = 0.00). There was no significant difference in any HRV variable (P > 0.05).

Pulsed LA, when applied in an individualized protocol, can reduce pain intensity, as reported on the PNS, GPI, and SSS. However, no therapeutic effect was observed for HRV.

Fibromyalgia (FM) is a chronic musculoskeletal syndrome characterized by pain and fatigue; however, its etiology remains unknown, and various hypotheses and biomarkers have been proposed. This study it is aimed to investigate blood biomarkers in the pathogenesis of FM. The current case-control study has been conducted on 45 females with the documented diagnosis of FM and 45 healthy controls referring to the outpatient clinic of rheumatology in 2018-19. The serum levels of dehydroepiandrosterone (DHEAS), erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), complete blood count (CBC), and thyroid-stimulating hormone (TSH) was measured and compared between the groups. DHEAS serum levels in cases and controls were 27.55±18.80 and 33.55±21.80, (P=0.16), ESR was 29.17±9.75 and 17.37±2.82 (P<0.001), CRP was 4.17±1.53 and 3.53±1.15 (P=0.02), TSH was 3.307±0.27 and 3.41±0.22 (P=0.09), respectively. The two groups were similar in CBC indices, including hemoglobin, hematocrit, white blood cell, lymphocyte, neutrophil, and platelet count (P>0.05). DHEAS was slightly, but insignificantly, lower among the females with FM than healthy cases. On the other hand, the serum ESR and CRP levels were remarkably higher among the females with FM; however, in the normal range, a fact representing the possible traces of inflammation in the pathogenesis of FM.