Salaberria Karmele, Ruiz-Iriondo María, Pérez-Fernández José I, Barandiarán Aitziber, Iruin Alvaro
Department of Clinical and Health Psychology and Research Methods, University of Basque Country, San Sebastian, Spain.
Neuroscience Department, BIODONOSTIA Health Research Institute, San Sebastian, Spain.
Psych J. 2023 Apr;12(2):319-329. doi: 10.1002/pchj.617. Epub 2022 Nov 20.
The aim of this study was to explore differential psychological profiles among patients with chronic pain with and without fibromyalgia, and to determine the results of the cognitive behavioral therapy (CBT) for pain. Thirty patients with chronic pain and 60 patients with fibromyalgia were referred to 10 weekly sessions of CBT in a general hospital and were evaluated in pain-related variables, psychopathological symptoms, coping strategies, resilience, and quality of life. The program was implemented in specific groups for patients with fibromyalgia and nonfibromyalgia chronic pain. After the intervention, patients with fibromyalgia showed higher levels of psychopathology, rated their health status as poorer, and presented larger amplification of symptoms, higher levels of somatization, a more ruminating style of thinking and greater distress. Patients without fibromyalgia achieved better therapeutic results in both pain intensity (d = 0.39 vs. d = 0.12) and psychopathological distress (d = 0.77 vs. d = 0.11) compared to patients with fibromyalgia. Therefore, differential profiles and limited therapeutic results in fibromyalgia patients suggest the need to outline differentiated treatments and include other therapeutic strategies.
本研究的目的是探讨伴有和不伴有纤维肌痛的慢性疼痛患者之间的不同心理特征,并确定认知行为疗法(CBT)对疼痛的治疗效果。30名慢性疼痛患者和60名纤维肌痛患者被转介到一家综合医院接受为期10周的CBT治疗,并在疼痛相关变量、心理病理症状、应对策略、心理韧性和生活质量方面进行评估。该项目针对纤维肌痛患者和非纤维肌痛慢性疼痛患者分别分组实施。干预后,纤维肌痛患者表现出更高水平的心理病理学症状,对自身健康状况的评价更差,症状放大更明显,躯体化水平更高,思维方式更爱反复思考,痛苦程度更大。与纤维肌痛患者相比,非纤维肌痛患者在疼痛强度(d = 0.39 vs. d = 0.12)和心理病理痛苦程度(d = 0.77 vs. d = 0.11)方面均取得了更好的治疗效果。因此,纤维肌痛患者的不同特征和有限的治疗效果表明需要制定差异化的治疗方案并纳入其他治疗策略。