认知行为疗法在控制纤维肌痛症状方面的效果能持续多久？一项前瞻性队列研究。

How durable are the effects of cognitive-behavioural therapy‎ in controlling fibromyalgia symptoms? A prospective cohort study.

作者信息

Zabihiyeganeh Mozhdeh, Afshar Sedigheh Vafaee, Kadijani Azade Amini, Janbozorgi Masoud, Akbari Abolfazl, Yahyazadeh Hooman, Mirzaei Alireza

机构信息

Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Musculoskeletal Care. 2023 Sep;21(3):890-894. doi: 10.1002/msc.1766. Epub 2023 Mar 28.

DOI:10.1002/msc.1766

PMID:36987397

Abstract

PURPOSE

Cognitive-behavioural therapy (CBT) is widely used for the treatment of fibromyalgia. However, there is no consensus on the durability of its effects on these patients. In this study, we evaluated how durable are the effects of CBT in controlling fibromyalgia symptoms.

METHODS

Forty-eight fibromyalgia patients treated with traditional face-to-face CBT were included. CBT was performed in 20 consecutive group sessions. To evaluate the durability of treatment, the effects of CBT on fibromyalgia symptoms were checked at five time-points: before the CBT, immediately after the CBT, 3 months after the CBT, 6 months after the CBT, and 12 months after the CBT. Outcome measures were the Fibromyalgia impact questionnaire (FIQ) and widespread pain index (WPI).

RESULTS

The mean FIQ score of the patients was 68.3 ± 18.8 before the CBT and 50.5 ± 14.1 1 week after the CBT (p < 0.001). The mean post-CBT FIQ score did not significantly change three and 6 months after the CBT (p = 0.11 and p = 0.09, respectively) while the positive effects of CBT significantly diminished after 12 months (p < 0.001). The mean WPI was 10.4 ± 3.6 before the CBT and 8.6 ± 3.1 1 week after the end of CBT (p < 0.001). The mean WPI of three and 6 months was not statistically different from that immediately after the CBT (p = 0.18 and p = 0.15, respectively), while after 12 months, it significantly worsened (p < 0.001).

CONCLUSION

CBT's beneficial effects for fibromyalgia patients are durable for 6 months. Complementary CBT sessions could be implemented to boost the CBT effect after this period.

摘要

目的

认知行为疗法（CBT）被广泛用于治疗纤维肌痛。然而，对于其对这些患者疗效的持久性尚无共识。在本研究中，我们评估了CBT在控制纤维肌痛症状方面的疗效能持续多久。

方法

纳入48例接受传统面对面CBT治疗的纤维肌痛患者。CBT以连续20组疗程进行。为评估治疗的持久性，在五个时间点检查CBT对纤维肌痛症状的影响：CBT前、CBT结束后即刻、CBT后3个月、CBT后6个月以及CBT后12个月。结局指标为纤维肌痛影响问卷（FIQ）和广泛性疼痛指数（WPI）。

结果

患者的平均FIQ评分在CBT前为68.3±18.8，CBT结束后1周为50.5±14.1（p<0.001）。CBT后3个月和6个月时，平均FIQ评分无显著变化（分别为p=0.11和p=0.09），而CBT的积极效果在12个月后显著减弱（p<0.001）。平均WPI在CBT前为10.4±3.6，CBT结束后1周为8.6±3.1（p<0.001）。3个月和6个月时的平均WPI与CBT结束后即刻无统计学差异（分别为p=0.18和p=0.15），而在12个月后，显著恶化（p<0.001）。