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

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.

The effect of cognitive behavioral therapy on the circulating proinflammatory cytokines of fibromyalgia patients: A pilot controlled clinical trial.

OBJECTIVES: There is no consensus over the effect size of cognitive behavioral therapy (CBT) in the treatment of fibromyalgia (FM). This study aims to evaluate the effect of CBT on FM patients, through assessing circulating proinflammatory cytokines. METHODS: A controlled, single-blind, parallel clinical trial was performed with 21 FM patients in each group. Sixteen FM patients in the intervention group (CBT) and 17 FM patients in the control group (waiting-list) completed the study. For the intervention group, traditional face-to-face CBT was performed for groups of 10 and 11 patients in 20 sessions. Fibromyalgia Impact Questionnaire (FIQ), widespread pain index (WPI), circulating IL-6, IL-8, and TNF-α level were evaluated before and after the intervention using enzyme-linked immunosorbent assay. Intention-to-treat analysis was performed as the primary analysis. RESULTS: The average changes of factors examined were as follows: FIQ score -0.61 ±â€¯5.5 in the waiting-list group and 10.2 ±â€¯14.9 in the CBT group (p = 0.012); WPI -0.33 ±â€¯1.1 in the waiting-list group and 2.4 ±â€¯3.1 in the CBT group (p = 0.002); serum IL-6 level -0.05 ±â€¯0.86 pg/ml in the waiting-list group and 1.5 ±â€¯2.4 pg/ml in the CBT group (p = 0.002); serum IL-8 level - 0.55 ±â€¯0.2.5 pg/ml in the waiting-list group and 5 ±â€¯5.9 pg/ml in the CBT group (p = 0.002); serum TNF-α level 0.67 ±â€¯1.8 pg/ml in the waiting-list group and 0.7 ±â€¯1.6 pg/ml in the CBT group (p = 0.89). CONCLUSION: Reductions in proinflammatory cytokines after CBT compared with a waiting-list control group confirm the potential value of these biomarkers as surrogate outcome measures in FM.

Lipid profile improvement after four group psychological interventions in combination to nutritional and physical activity instructing among overweight and obese individuals.

BACKGROUND: Research background approved weight loss would result in improvement of lipid profile. Nowadays, weight management is attained by modifying psychological mediators, as well as dieting and making individuals do more physical activity. Hence, This research was performed to compare effectiveness of different psychological interventions on lipid profile improvement among individuals with overweight and obesity. METHODS: Using quasi-experimental design, 68 participants with mean age 26 years and 9 months (ranged from 20 to 43) were randomly assigned into 4 groups (including LEARN, CBT, CT, and MCT), and eventually 61 participants completed the treatment protocols. BMI was calculated by Omron digital body composition instrument, and blood lipids and glucose concentrations were measured prior to and after all interventions. RESULTS: Data analysis by using t-test for dependent groups analysis revealed lipid profile, FBS, and BMI were significantly modified after applying 4 interventions comparing baseline and post treatment mean differences(P<0.05). Furthermore, repeated measure design analysis showed there were significant mean differences (P<0.05) in HDL cholesterol, TG levels and FBS levels among 4 groups. Scheffe test revealed more detailed significant differences among four groups in HDL cholesterol, and FBS concentration varieties (P<0.05). CONCLUSIONS: Adding psychological interventions to dietary plans and regular physical activities in overweight management would consider as a valuable step in optimizing physiological outcomes and that's because of correcting mind-body interactional pathways among obese and overweight individuals.

Assessment of Defense Styles and Mechanisms in Iranian Patients Suffering from Obsessive Compulsive or Panic Disorders versus Normal Controls using Persian Version of Defense Style Questionnaire-40.

OBJECTIVE: The aim of this study was to compare defense styles and mechanisms in adult patients suffering from obsessive-compulsive disorder (OCD), and panic disorder (PD) with normal subjects in Iran. METHODS: Defensive patterns of 22 patients with OCD, 28 patients with PD and those of 116 normal individuals (as a control group) were assessed using the Farsi version of Defense Style Questionnaire-40 (DSQ-40). The content validity of this questionnaire was done prior to the initiation of the present study. RESULTS: Both groups of patients with OCD or PD used more immature and less mature styles compared to the control group. No significant difference was observed in the use of neurotic style between the two groups. CONCLUSION: It is suggested that immature defenses may have an important role in the pathogenesis of OCD and PD.

Admissibility Investigation and Validation of Infertility Distress Scale (IDS) in Iranian Infertile Women.

BACKGROUND: Psychological stress has a profound effect on infertility and its treatment. The aim of this study was to develop a specific scale to determine distress levels among Iranian infertile women. MATERIALS AND METHODS: In this cross-sectional study the samples included 300 women (145 fertile and 155 infertile) who completed the Infertility Distress Scale (IDS) form. Data was analysed using correlation method and main component analysis. RESULTS: These results show that all 21 items had a high correlation with the overall scale. Cronbach's alpha value was 0.91 for the entire list. Factor analysis results with 5 element extraction could identify 88% of overall variance with a special value higher than 1. CONCLUSION: According to results, the IDS questionnaire has enough admissibility and va- lidity in the measurement of the infertility distress scale in Iranian infertile women.