Lami María J, Martínez María P, Sánchez Ana I, Miró Elena, Diener Fabián N, Prados German, Guzmán Manuel A
Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain.
Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.
Pain Pract. 2016 Feb;16(2):E23-34. doi: 10.1111/papr.12411.
Fibromyalgia (FM) is a chronic musculoskeletal pain syndrome that significantly affects patients' quality of life. Its main symptoms are pain, fatigue, and sleep disturbances.
The aim of this study was to assess the efficacy of cognitive-behavioral therapy for insomnia (CBT-I) in men and women with FM and compare sleep and clinical features between both genders.
Fifteen women and 13 men were selected to participate in nine weekly CBT-I sessions that involved completing several self-reported questionnaires at pretreatment, post-treatment, and follow-up. Patients were recruited from the Rheumatology Service and Pain Unit of Hospital and a fibromyalgia association. Group psychotherapy was performed at clinical unit of the Faculty of Psychology.
Both groups showed significant clinical and statistical improvements in sleep quality and the main symptoms associated with FM (ie, pain intensity, fatigue, anxiety, pain catastrophizing, and pain-related anxiety). Differential treatment responsiveness between sexes was observed. Male group exhibited significant changes at post-treatment in sleep disturbances and pain-related anxiety and catastrophizing. The female group showed post-treatment improvements in sleep latency, general fatigue, and depression, which persisted at follow-up.
Differential responses to treatment between men and women were observed in some sleep- and pain-related variables. Outcomes show the needed to design different treatments for men and women with FM is discussed.
纤维肌痛(FM)是一种慢性肌肉骨骼疼痛综合征,严重影响患者的生活质量。其主要症状为疼痛、疲劳和睡眠障碍。
本研究旨在评估失眠认知行为疗法(CBT-I)对患有纤维肌痛的男性和女性的疗效,并比较两性之间的睡眠和临床特征。
选取15名女性和13名男性参加为期九周的CBT-I课程,课程包括在治疗前、治疗后和随访时完成几份自我报告问卷。患者从医院的风湿病科和疼痛科以及一个纤维肌痛协会招募。团体心理治疗在心理学院的临床科室进行。
两组在睡眠质量以及与纤维肌痛相关的主要症状(即疼痛强度、疲劳、焦虑、疼痛灾难化和疼痛相关焦虑)方面均显示出显著的临床和统计学改善。观察到两性之间存在不同的治疗反应。男性组在治疗后睡眠障碍、疼痛相关焦虑和灾难化方面有显著变化。女性组在治疗后睡眠潜伏期、全身疲劳和抑郁方面有所改善,这些改善在随访时持续存在。
在一些与睡眠和疼痛相关的变量中观察到男性和女性对治疗的不同反应。讨论了针对患有纤维肌痛的男性和女性设计不同治疗方法的必要性。