Cognitive behavioral therapy with and without biofeedback in fibromyalgia: Assessment of functional and clinical change.

The study compared the effectiveness of Cognitive Behavioral Therapy (CBT) with biofeedback or with emotional expression in individuals with fibromyalgia, and a waiting list control group. 88 women participated in a naturalistic study with random assignment. The Fibromyalgia Impact Questionnaire, SCL-90R, and a visual analog quality of life scale were used. Both intervention groups improved, but differed in physical and emotional control response. Using the reliable change index procedure, clinical improvement occurred in 18.8% of participants, and 4.8% achieved scores comparable with clinical recovery. Greater specificity on therapeutic objectives is warranted.

The effects of an intervention to improve mental health during the COVID-19 quarantine: comparison with a COVID control group, and a pre-COVID intervention group.

ObjectiveThe COVID-19 pandemic has constituted an unprecedented challenge to society and science and it has provided an unexpected opportunity to explore the effects of a positive intervention in times of adversity and confinement. The goal was to evaluate the effects of a theory driven group intervention to cultivate mental health and flourishing. Design: A pre post design with three groups (151 individuals) was conducted, including an experimental group that received the intervention during the pandemic, a pre-COVID intervention group, and a COVID control group. Main Outcome Measures: Based on Keyes' concept of positive mental health, measures of subjective, psychological and social well-being were obtained, as well as an indicator of psychological distress (GHQ12). Results: Intervention groups showed an increase in well-being and the COVID control group a decrease. Change scores revealed significant differences. Overall percentage of individuals at risk of ill health in baseline was 25.2%, but after the intervention, the COVID control group reached 64.1%. Conclusions: Despite the limitations, the present findings suggest that interventions to sustain and improve mental health in times of crisis and adversity can be an effective approach.

A taxonomy of groups at risk based on reported and desired body mass index and its relationships with health.

This study aimed to identify groups at risk based on reported and desired Body Mass Index (BMI) and their relationships with weight satisfaction, food intake and perceived health, and to analyze gender differences. A pre-experimental observational study was conducted. 3380 individuals (mean age 20.16; 64.4% females) participated in a survey in the context of a healthy university project. Participants anonymously completed the SF-12, reported height, weight, desired weight, satisfaction and quality of intake. Reported BMI (BMI-r) and Desired BMI (BMI-d) were calculated following WHO standards. Combining BMI-r and BMI-d four groups emerged: Favorable Concordance, FC (67.40% normal weight wanting to maintain it), Unfavorable Concordance, UC (9.19% non-normal weight wanting such unhealthy condition), Favorable Discrepancy, FD (13.92% unhealthy weight wanting to move in a healthy direction), and Unfavorable Discrepancy, UD (9.49% normal or non-normal weight desiring an unhealthy condition). FD individuals showed lower levels of self-perceived physical health, poorer perception of the quality of their intake, and less satisfaction with weight. Both UD and UC groups are at risk, showing the UD group the lowest scores in mental health and healthy food intake. Higher proportions of females were found in the UD group, and wanting to lose weight. These findings suggest that health treatment, prevention and promotion programs can benefit from a taxonomy that identifies not only people at risk but the direction and adjustment (i.e. healthy vs non healthy) of their intention to change. Programs could be targeted at different groups, with specific goals and interventions, and avoid the 'one-fits-all' to foster a healthy weight in the young adult university population.

Design and evaluation of a positive intervention to cultivate mental health: preliminary findings.

The past two decades have witnessed a proliferation of positive psychological interventions for clinical and non-clinical populations, and recent research, including meta-analyses, is providing evidence of its effectiveness. Most interventions have focused on increasing life satisfaction, positive affect, and psychological well-being. Manualized, multi-component interventions based on a comprehensive theory are scarce. Keyes' concept of mental health and flourishing (subjective, psychological, and social well-being) is an overarching theoretical framework to guide the design of a multi-component psychological intervention to cultivate well-being and personal development. Therefore, the purpose of this study was to design a theory-driven positive intervention and to pilot test the intervention. The manual presents an 8-week group program that includes homework activities. A sample of 56 young adults completed the intervention. Participants were assessed at base line, after termination, and at a 6-month follow-up session. Standardized instruments were used to assess the dimensions of mental health proposed by Keyes. Pre- and post-test measures of subjective, psychological, and social well-being showed significant differences, as did the total mental health scores. At 6-month follow-up, differences remained in subjective and psychological well-being and in positive mental health, with smaller effect sizes. Limitations of these preliminary findings as well as future lines of research and improvements in this manualized intervention are proposed in the light of current research on positive interventions.

Design and evaluation of a positive intervention to cultivate mental health: preliminary findings

Abstract The past two decades have witnessed a proliferation of positive psychological interventions for clinical and nonclinical populations, and recent research, including meta-analyses, is providing evidence of its effectiveness. Most interventions have focused on increasing life satisfaction, positive affect, and psychological well-being. Manualized, multi-component interventions based on a comprehensive theory are scarce. Keyes' concept of mental health and flourishing (subjective, psychological, and social well-being) is an overarching theoretical framework to guide the design of a multi-component psychological intervention to cultivate well-being and personal development. Therefore, the purpose of this study was to design a theory-driven positive intervention and to pilot test the intervention. The manual presents an 8-week group program that includes homework activities. A sample of 56 young adults completed the intervention. Participants were assessed at base line, after termination, and at a 6-month follow-up session. Standardized instruments were used to assess the dimensions of mental health proposed by Keyes. Pre- and post-test measures of subjective, psychological, and social well-being showed significant differences, as did the total mental health scores. At 6-month follow-up, differences remained in subjective and psychological well-being and in positive mental health, with smaller effect sizes. Limitations of these preliminary findings as well as future lines of research and improvements in this manualized intervention are proposed in the light of current research on positive interventions.

Gut microbiome and serum metabolome analyses identify molecular biomarkers and altered glutamate metabolism in fibromyalgia.

BACKGROUND: Fibromyalgia is a complex, relatively unknown disease characterised by chronic, widespread musculoskeletal pain. The gut-brain axis connects the gut microbiome with the brain through the enteric nervous system (ENS); its disruption has been associated with psychiatric and gastrointestinal disorders. To gain an insight into the pathogenesis of fibromyalgia and identify diagnostic biomarkers, we combined different omics techniques to analyse microbiome and serum composition. METHODS: We collected faeces and blood samples to study the microbiome, the serum metabolome and circulating cytokines and miRNAs from a cohort of 105 fibromyalgia patients and 54 age- and environment-matched healthy individuals. We sequenced the V3 and V4 regions of the 16S rDNA gene from faeces samples. UPLC-MS metabolomics and custom multiplex cytokine and miRNA analysis (FirePlex™ technology) were used to examine sera samples. Finally, we combined the different data types to search for potential biomarkers. RESULTS: We found that the diversity of bacteria is reduced in fibromyalgia patients. The abundance of the Bifidobacterium and Eubacterium genera (bacteria participating in the metabolism of neurotransmitters in the host) in these patients was significantly reduced. The serum metabolome analysis revealed altered levels of glutamate and serine, suggesting changes in neurotransmitter metabolism. The combined serum metabolomics and gut microbiome datasets showed a certain degree of correlation, reflecting the effect of the microbiome on metabolic activity. We also examined the microbiome and serum metabolites, cytokines and miRNAs as potential sources of molecular biomarkers of fibromyalgia. CONCLUSIONS: Our results show that the microbiome analysis provides more significant biomarkers than the other techniques employed in the work. Gut microbiome analysis combined with serum metabolomics can shed new light onto the pathogenesis of fibromyalgia. We provide a list of bacteria whose abundance changes in this disease and propose several molecules as potential biomarkers that can be used to evaluate the current diagnostic criteria.

Fibromyalgia: effect of a cognitive behavioral treatment with and without biofeedback on psychopathological symptoms / Fibromialgia: efecto de un tratamiento cognitivo conductual con y sin biofeedback en los síntomas psicopatológicos

The purpose of the study was to design two cognitive behavioral treatments (CBT) for people with fibromyalgia (FM): therapy with electromyographic biofeedback (T1) and therapy without biofeedback (T2); and to assess their effects on psychopathological symptoms. The study was carried out with 88 people diagnosed with FM, aged between 26 and 65 years; 33 received T1, 33 received T2, and 22 were assigned to a control group without treatment. An evaluation was performed before and after a treatment of 10 sessions with the "Symptom Checklist-90-Revised" the "State-Trait Anxiety Inventory" the "Beck Depression Inventory" and "State-Trait Anger Expression Inventory". The results showed that participants who had received a treatment decreased symptoms of hostility, state-anxiety, trait-anxiety, depression, trait-anger, and anger expression (p< .05). The effects of the two treatments were similar, and no significant group differences were found for any variable. The control group decreased less the symptoms, increasing anxiety and anger. This work provides an efficacious tool to reduce psychopathological symptoms and negative feelings in people with FM

El estudio tuvo como objetivo diseñar dos tratamientos cognitivo conductuales (TCC) para personas con fibromialgia (FM), uno con biofeedback electromiográfico (T1) y otro sin biofeedback (T2), y evaluar sus efectos en síntomas psicopatológicos. El estudio se realizó con 88 personas con diagnóstico de FM, entre 26 y 65 años, 33 recibieron el T1, 33 el T2 y 22 fueron el grupo control sin tratamiento. Se realizó una evaluación antes y después del tratamiento de 10 sesiones con el "Listado de 90 síntomas-revisado", el "Inventario de ansiedad estado-rasgo", el "Inventario de depresión de Beck" y el "Inventario de expresión de ira estado-rasgo". Los resultados muestran que los pacientes que recibieron algún tratamiento disminuyeron en síntomas de hostilidad, ansiedad estado, ansiedad-rasgo, depresión, ira-rasgo y expresión de sentimientos de ira (p< 0,05). Los efectos de ambos tratamientos fueron similares, no se hallaron diferencias significativas entre ellos en ninguna variable. El control disminuyó menos los síntomas, aumentando en ansiedad e ira. El trabajo aporta una herramienta eficaz para la reducción de síntomas psicopatológicos y sentimientos negativos en personas con FM

Síntomas psicopatológicos en personas con fibromialgia: Una reflexión / Psychopathological symptoms in people with fibromyalgia: A reflection

El estudio realizado tuvo como objetivos comparar si existen diferencias en diversos síntomas psicopatológicos entre personas con y sin Fibro­mialgia (FM) de ambos sexos y analizar el inicio de los síntomas en la biografía de las personas con FM. Participaron 190 sujetos españoles: 140 con FM y 50 sin FM (10 varones, 180 mujeres). Con un diseño descriptivo y comparativo de corte transversal, se administró el Cuestionario de 90 Síntomas-Revisado (SCL-90-R). Los ANOVAs confirmaron que: (1) las personas con FM de ambos sexos comparadas con las que no tienen FM muestran puntuaciones medias significativamente más altas en todos los síntomas psicopatológicos (somatización, obsesión-compulsión, sensibilidad interpersonal, depresión, ansiedad, hostilidad, ansiedad fóbica, ideación paranoide, psicoticismo) y en los tres índices. Los síntomas más frecuentes fueron los de somatización, obsesión-compulsión, depresión y ansiedad, (2) las personas con FM comparadas con la muestra no-clínica del test tenían puntuaciones percentilares mayores o iguales a 95 en muchos síntomas (somatización, obsesión-compulsión, sensibilidad interpersonal, depresión, ansiedad) y en todos los índices. En el Índice Sintomático General (GSI) el 94.3% obtuvo percentiles mayores o iguales a 80. Sin embargo, comparadas con la muestra clínica del test (pacientes psiquiátricos), únicamente tuvieron percentiles altos (≥ 90) en somatización, y en el GSI solo el 30.7% tuvo percentiles mayores o iguales a 80 y (3) únicamente el 23.6% de las personas con FM presentó antecedentes psicopatológicos / psiquiátricos previos, lo que sugiere que la psicopatología en muchos pacientes se desarrolla después de la FM. El estudio realizado tiene importantes implicaciones para el tratamiento de la FM.

Fibromyalgia (FM) is a chronic syndrome of unknown etiology, complex and variable evolution, provoking generalized pain that can become incapacitating. It affects the biological, psychological, and social spheres, and is an important health problem due to its prevalence, morbidity, and high rates of use and consumption of health resources. FM is described as the existence of generalized pain of more than three months' duration, absence of other causal pathology, and comorbidity with other syndromes and symptoms, such as chronic fatigue, nonremedial sleep, cognitive deficit, and numerous somatic and emotional symptoms, such as anxiety and depression. In 1992, FM was recognized by the World Health Organization and typified in the International Classification of Diseases (CIE-10) within rheumtological diseases. The prevalence of FM in developed countries is between 1 and 4%, and in Spanish population, it is 2.4%, with 4.2% infemales and .2% in males. Although many studies agree about the presence of psychopathology in FM, its frequency and intensity are variable and there is little evidence about the premorbid situation of the affected people, and therefore, about role of psychopathology in its pathogenesis. It is known that many people with FM have psychopathological symptoms (anxiety, depression), but the studies differ about whether psychopathology is the origin of FM or whether all people with FM have psychopathological disorders. The goals of the study were to determine possible differences in diverse psychopathological symptoms in people of both sexes with and without FM and to analyze the onset of the symptoms in the biography of people with FM. The study was performed with 190 Spanish participants, 140 with FM (73.7%) and 50 without FM (26.3%). The participants were aged between 28 and 75 years (M = 52.16; SD ­= 9.18), 10 were male (5.3%) and 180 female (94.7%). A descriptive, comparative, cross-sectional design was used and the 90-Symptoms Checklist Revised (SCL-90-R - Derogatis,1983 /2002) was administered. The ANOVAs confirmed that: (1) compared with people who did not have FM, people with FM of both sexes obtained significantly higher mean scores in all the psychopathological symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism) and in all three indices. The most frequent symptoms were somatization, obsession-compulsion, depression, and anxiety; (2) compared with the nonclinical sample of the test, people with FM had percentile scores greater than or equal many symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety) and in all the indices. In the Global Severity Index (GSI), 94.3% of FM patients obtained percentiles of greater than or equal 80. However, compared with the clinical sample of the test (psychiatric patients), FM patients only obtained high percentiles (≥ 90) in somatization, and in the GSI, only 30.7% obtained percentiles greater than or equal 80; and (3) only 23.6% of the people with FM presented prior psychiatric / psychopathological antecedents, suggesting that, in many patients, psychopathology develops after FM. To conclude, we confirm the emotional suffering undergone by most people with FM, and the psychologist's importance in the multidisciplinary treatment of this disease. Beyond the debate about whether psychopathological symptoms are the cause or the effect of FM, empirical evidence reveals a high level of psychopathological symptoms (especially somatization, obsession-compulsion, anxiety, and depression) in a large part of the people with FM, which allows us to emphasize the great support that mental health professionals can provide to these patients. The study has important implications for the treatment of FM.