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1.
Medicine (Baltimore) ; 99(4): e18833, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977878

RESUMO

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain and multiple symptoms. It is a common clinical condition whose etiology is unclear. Currently, there is no gold standard treatment for FM. Management of this condition is therefore aimed at reducing symptoms and maintaining the individual's ability to function optimally. Based on the principal symptoms and characteristics of individuals with FM, we hypothesized that the implementation of a multicomponent treatment (with physical exercise, cognitive behavioral therapy adding to a graded motor imagery program, and therapeutic neuroscience education) would be more effective than conventional treatment in women with FM. This paper describes the rationale and methods of study intended to test the effectiveness of multicomponent treatment versus conventional treatment in patients with FM. METHOD/DESIGN: Fifty-six female individuals between 18 and 65 years of age, who were referred to the physical therapy department of the Rehabilitar Center in Chile, will be randomized into two treatment arms. The intervention group will receive a multicomponent treatment program for duration of 12 weeks. The control group will receive a conventional treatment for this condition for 12 weeks. The primary outcome measure will be the pain intensity score, measured by the numeric pain rating scale (NPRS), and the secondary outcomes will be the FM Impact Questionnaire (FIQ), and affective components of pain, such as catastrophizing using the Pain Catastrophizing Scale (PCS), fear of movement using the Tampa Scale Kinesiophobia (TSK), and sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). DISCUSSION: This paper reports the design of a randomized clinical trial aimed at assessing the effectiveness of the multicomponent treatment versus conventional treatment in women with FM. TRIAL REGISTRATION: Brazilian registry of clinical trials UTN number U1111-1232-0862. Registered 22 April 2019.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Fibromialgia/terapia , Adulto , Idoso , Catastrofização/prevenção & controle , Catastrofização/psicologia , Feminino , Fibromialgia/psicologia , Humanos , Pessoa de Meia-Idade , Dor/psicologia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
2.
Medicine (Baltimore) ; 98(41): e17289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593081

RESUMO

INTRODUCTION: Fibromyalgia (FM) is a chronic condition characterized by chronic pain, fatigue and loss of function which significantly impairs quality of life. Although treatment of FM remains disputed, some studies point at the efficacy of interdisciplinary therapy. This study aims to analyze the effectiveness, cost-utility and benefits of a multicomponent therapy on quality of life (main variable), functional impact, mood and pain in people suffering from FM that attend primary care centers (PCCs) of the Catalan Institute of Health (ICS). METHODS AND ANALYSIS: A 2-phase, mixed methods study has been designed following Medical Research Council guidance. Phase 1: Pragmatic randomized clinical trial with patients diagnosed with FM that attend one of the 11 PCCs of the ICS Gerència Territorial Terres de l'Ebre. We estimate a total sample of 336 patients. The control group will receive usual clinical care, while the multicomponent therapy group (MT group) will receive usual clinical care plus group therapy (consisting of health education, exercise and cognitive-behavioural therapy) during 12 weeks in 2-hourly weekly sessions. ANALYSIS: the standardized mean response and the standardized effect size will be assessed at 3, 9, and 15 months after the beginning of the study using multiple linear regression models. Utility measurements will be used for the economic analysis. Phase 2: Qualitative socio constructivist study to evaluate the intervention according to the results obtained and the opinions and experiences of participants (patients and professionals). We will use theoretical sampling, with 2 discussion groups of participants in the multicomponent therapy and 2 discussion groups of professionals of different PCCs. A thematic content analysis will be carried out. ETHICS AND DISSEMINATION: This study protocol has been approved by the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (code P18/068). Articles will be published in international, peer-reviewed scientific journals. TRIAL REGISTRATION: Clinical-Trials.gov: NCT04049006.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Fibromialgia/terapia , Educação de Pacientes como Assunto/métodos , Atenção Primária à Saúde/métodos , Qualidade de Vida , Adulto , Terapia Cognitivo-Comportamental/economia , Terapia Combinada , Análise Custo-Benefício , Terapia por Exercício/economia , Estudos de Viabilidade , Feminino , Fibromialgia/economia , Fibromialgia/psicologia , Implementação de Plano de Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Cooperação do Paciente , Educação de Pacientes como Assunto/economia , Atenção Primária à Saúde/economia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
3.
Isr Med Assoc J ; 21(7): 449-453, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31507119

RESUMO

BACKGROUND: Fibromyalgia is a syndrome of unknown etiology that is characterized by widespread pain, which severely impairs quality of life. Several forms of occupational and alternative therapy have demonstrated beneficial effects in fibromyalgia patients. OBJECTIVES: To assess the effects of participation in a floral design course on physical and psychiatric symptoms in a cohort of fibromyalgia patients. METHODS: This study was conducted as an observational study. Women diagnosed with fibromyalgia over the age of 18 were recruited to participate in one of two 12-week flower design (floristry) courses. Demographic details, disease activity indices, and anxiety and depression scores were calculated for all participants at baseline, week 12, and study completion. Physical and mental health of the two groups were compared throughout the study time-points. RESULTS: The study was completed by 61 female fibromyalgia patients who were included in the final analyses; 31 patients participated in the first floristry course and 30 in the second. Significant improvements in the 36-Item Short Form Survey physical and mental health components, visual analog scale, Fibromyalgia Impact Questionnaire, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale scores for the entire study population and for each group separately could be seen following participation in each floristry course. CONCLUSIONS: Participation in a floristry course may lead to a significant improvement in pain and psychiatric symptoms in fibromyalgia patients. These findings highlight the potential benefit of utilizing occupational therapy programs, such as a floristry course, for improving quality of life in fibromyalgia.


Assuntos
Ansiedade/terapia , Terapias Complementares/métodos , Depressão/terapia , Fibromialgia/terapia , Qualidade de Vida , Adulto , Idoso , Ansiedade/psicologia , Estudos de Coortes , Depressão/psicologia , Feminino , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Flores , Humanos , Pessoa de Meia-Idade , Medição da Dor , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários
4.
Artigo em Inglês | MEDLINE | ID: mdl-31480366

RESUMO

What physical qualities can predict the quality of life (QoL) in women with fibromyalgia (FM)? QoL is a very complex outcome affected by multiple comorbidities in people with fibromyalgia. This study aims to determine which physical qualities can predict the quality of life in women with FM. Also, a comparison between the physical qualities of women with FM and healthy counterparts was conducted. In total, 223 women participated in this cross-sectional study, 123 with FM, with ages ranging between 45 and 70 years. The study was conducted at several fibromyalgia associations and specialized medical units. QoL was measured as the main outcome. In addition, functional capacity, muscular strength, maintenance of thoracic posture, postural control, flexibility, pain threshold, and anxiety were measured. Prediction of the QoL was conducted with multiple linear regression analysis and comparison between groups, using the Mann-Whitney U test. There were significant differences between groups in all the variables measured (p < 0.01). The multiple linear regression model showed that factors influencing QoL in women with FM for all the variables measured were functional capacity, handgrip strength and bicep strength, maintenance of thoracic posture, pain threshold, and anxiety (R2 = 0.53, p < 0.05). To conclude, women with FM show a significantly lower QoL than their healthy counterparts, and the factors that predict their perceived QoL are functional capacity, muscular strength, postural maintenance, pain threshold, and anxiety.


Assuntos
Constituição Corporal , Fibromialgia/psicologia , Qualidade de Vida , Idoso , Ansiedade , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Força Muscular , Limiar da Dor , Equilíbrio Postural , Espanha
5.
Med Sci Monit Basic Res ; 25: 169-178, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31273184

RESUMO

Fibromyalgia (FM) is a centralized pain state that until recently has been shrouded in mystery and questionable as a disease entity in the eyes of many physicians, who considered it purely psychogenic. Fibromyalgia is now thought of as a discrete diagnosis with a clustering of symptoms characterized by central nervous system pain amplification along with anergia, memory loss, disturbances of mood, and sleep disruption. The condition is present in approximately 2% to 8% of the population. We review the link between inflammatory mechanisms and FM from a neuropsychiatric perspective. Recent studies are pointing to a neuroinflammatory etiology that may open up more effective treatment strategies in the future. Better conceptualization of FM may also elucidate a neuropsychiatric understanding of how nociception, dysthymia, and suicidality co-develop and feed off one another.


Assuntos
Fibromialgia/psicologia , Neuropsiquiatria , Depressão/psicologia , Fibromialgia/microbiologia , Fibromialgia/patologia , Humanos , Microbiota , Microglia/patologia , Dor/patologia
6.
Trends Psychiatry Psychother ; 41(2): 128-135, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291411

RESUMO

OBJECTIVE: This study aimed to identify and analyze the interaction structures (ISs) (patterns of reciprocal interaction between the patient-therapist dyad) that characterize the process of a successful long-term psychodynamic psychotherapy (28 months) of a patient with chronic diseases (lupus and fibromyalgia) and somatic symptoms. METHODS: The 113 sessions were videotaped and analyzed alternately (n = 60) by independent judges using the Psychotherapy Process Q-Set. Inter-rater reliability ranged from 0.60 to 0.90, with a mean of r = 0.71 (Pearson's correlation). Through a principal component exploratory factor analysis, four ISs were identified. RESULT: The patterns of interaction between patient and therapist showed clinical validity (i.e., they were easily interpretable in the context of the case under study). The ISs were non-linear and more or less prominent across different treatment sessions and stages. Some ISs were similar to those in other studies, and others were probably unique to the present process. In addition, some ISs were independent, whereas others were interrelated over time. CONCLUSION: Process studies, such as the present one, seek to address questions about the characteristics of the interaction between patient and therapist as well as to identify particular patterns of interaction that are most prominent with a specific patient at a specific condition or time. Therefore, these studies can provide some support in establishing knowledge for clinical practice, assisting in the training of therapists, as well as in the elaboration of general guidelines for the technical management of patients with specific characteristics.


Assuntos
Fibromialgia/psicologia , Lúpus Eritematoso Sistêmico/psicologia , Relações Profissional-Paciente , Psicoterapia Psicodinâmica , Aliança Terapêutica , Idoso , Emoções , Feminino , Humanos
8.
Pain Res Manag ; 2019: 6584753, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31191788

RESUMO

Although the life-course concept of risk markers as potential etiological influences is well established in epidemiology, it has not featured in academic publications or clinical practice in the context of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS). Studies of risk markers are required considerations for evaluation of patients and for research because there is no single cause, pathological feature, laboratory finding, or biomarker for CWP or FMS. The early-life risk markers identified by extensive literature review with best evidence for potential causal influence on the development and progression of CWP and FMS include genetic factors, premature birth, female sex, early childhood adversity, cognitive and psychosocial influences, impaired sleep, primary pain disorders, multiregional pain, physical trauma, infectious illness, obesity and inactivity, hypermobility of joints, iron deficiency, and small-fiber polyneuropathy. The case history illustrates the potential etiological influence of multiple risk markers offset by personal resilience.


Assuntos
Dor Crônica/etiologia , Dor Crônica/psicologia , Fibromialgia/etiologia , Fibromialgia/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Fatores de Risco
9.
Br J Health Psychol ; 24(3): 687-703, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31231929

RESUMO

OBJECTIVES: The aim of the current research was to evaluate, in people with fibromyalgia, the extent to which beliefs about sharing illness experiences are associated with functioning and distress, and to explore the mediating role of illness behaviours. A new scale was designed to address this. DESIGN: The Beliefs about Sharing Illness Experiences (BASIE) scale was developed, and initial tests of reliability and validity were conducted. A cross-sectional design was used to determine relationships, including mediation analyses. METHODS: Individuals with fibromyalgia (n = 147) and a comparison group of individuals without fibromyalgia (n = 47) completed questionnaires online. Construct validity was assessed by comparing these two groups. Convergent validity was assessed through correlations with the BASIE and measures of support-seeking and self-sacrifice. Correlation analyses were used to determine relationships with illness behaviours and outcome measures (distress and global impact). Mediation analyses were used to test the indirect effects of illness behaviours. RESULTS: The BASIE was correlated with expected convergent measures and had good internal consistency (Cronbach's alpha = .939). Individuals with fibromyalgia had significantly higher scores than the comparison group. There was a direct relationship between BASIE scores and outcomes, in terms of functioning and distress. The relationship between BASIE scores and functioning was partially mediated by personal/emotional support-seeking and all-or-nothing behaviours, and not by symptom-related support-seeking or limiting behaviours. CONCLUSION: Beliefs about sharing illness experiences may be a key factor in maintaining cycles of distress and symptoms in people with fibromyalgia, together with all-or-nothing behaviours and personal/emotional support-seeking. Statement of contribution What is already known on this subject? Maintenance of fibromyalgia is likely to be a complex autopoietic relationship including symptoms, beliefs, behaviours, and emotions. Research suggests possible roles of beliefs about unacceptability of emotions and beliefs around interpersonal situations, and behaviours in social situations as well as limiting and all-or-nothing behaviours. People with fibromyalgia may experience stigma, sometimes resulting in secrecy around their condition and symptoms. What does this study add? The BASIE is a 21-item questionnaire that measures beliefs around sharing illness experiences. Individuals with fibromyalgia hold stronger beliefs around unacceptability of sharing illness experiences. These beliefs are related to functioning and distress, partially mediated by illness behaviours.


Assuntos
Atitude Frente a Saúde , Emoções , Fibromialgia , Adulto , Estudos Transversais , Cultura , Feminino , Fibromialgia/psicologia , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários
10.
Medicine (Baltimore) ; 98(19): e15564, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083224

RESUMO

Depression is one of the most common mental health problems which affects more than 10% of the global population. The prevalence of this disorder is higher in fibromyalgia patients. However, the influence of the combination of depression and fibromyalgia in the brain processing is poorly understood.To explore the modifications of EEG power spectrum in women with fibromyalgia when depressive feelings are elicited.Twenty eight women with fibromyalgia participated in this cross-sectional study. They were classified as women with depression or women without depression according to the score in the Geriatric Depression Scale. This questionnaire was used to elicit depression symptoms during the EEG recording. Analyses were performed with the standardized LOw Resolution Electric Tomography (sLORETA) software. Power spectrum were compared in the following frequency bands: delta, theta, alpha-1, alpha-2, beta-1, beta-2, and beta-3.Fibromyalgia patients with untreated depression showed a hypoactivation of the left hemisphere when compared with fibromyalgia patients without depression. In addition, when compared fibromyalgia patients without depression and women with both fibromyalgia and depression who were taking antidepressant medications, differences in EEG power spectrum in the studied frequency bands were not found.The current study contributes to the understanding on the influence of the combination of fibromyalgia and depression in the brain activity patterns. Patients with untreated depression showed a hypoactivation of the left hemisphere while eliciting depression symptoms. However, further research is needed, antidepressant medication might reduce the differences between patients with depression and those who do not suffer from depression symptoms.


Assuntos
Encéfalo/fisiopatologia , Depressão/fisiopatologia , Transtorno Depressivo/complicações , Transtorno Depressivo/fisiopatologia , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Antidepressivos/uso terapêutico , Estudos Transversais , Depressão/complicações , Transtorno Depressivo/tratamento farmacológico , Eletroencefalografia , Feminino , Fibromialgia/complicações , Humanos , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica
11.
Pediatr Rheumatol Online J ; 17(1): 21, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31072338

RESUMO

BACKGROUND: Health-related quality of life (HRQoL) measures serve as important indicators of pain-related physical and psychosocial function in youth with juvenile fibromyalgia syndrome (JFMS). While the administration of parent-proxy reported HRQoL measures in the assessment of JFMS is common, its added clinical value to patient self-reports is unclear. We aimed to determine the level of agreement on HRQoL among patients with JFMS as well as their parent-proxies and to determine factors associated with this agreement. METHODS: We performed a retrospective, cross-sectional cohort study of children aged 8 to 17 years diagnosed with JFMS and presenting for initial evaluation to a pediatric rheumatology pain clinic between April 2017 and May 2018. All patients and proxies were administered the Pediatric Quality of Life Short Form 15 Generic Core Scales (PedsQL SF-15) as part of routine clinical care. We calculated absolute discrepancy scores (absolute value of parent-proxy score minus patient score) to describe the extent of difference in HRQoL scores between parent-proxies and patients. We examined agreement between parent-proxy report and patient self-report via intraclass correlation coefficients (ICCs), stratified by age and sex, as well as Bland-Altman plots. We also used multivariate regression models to determine factors associated with level of agreement. RESULTS: A total of 65 patient-proxy pairs were included in this study. ICCs demonstrated good to excellent agreement between all parent-proxy and patient measures of HRQoL irrespective of the patient's age or sex. The level of agreement was not associated with pain duration or pain severity but less agreement on psychosocial HRQoL was associated with older patient age (ß = 1.30; p < 0.05). CONCLUSIONS: This study in youth with JFMS demonstrated good to excellent patient-proxy agreement across all domains of the PedsQL SF-15 irrespective of patient's age or sex. Our findings suggest that parent-proxy reports do not provide additional information beyond that obtained from the patient self-report of HRQoL according to the PedsQL SF-15. In order to facilitate children and adolescents with JFMS becoming partners in their own healthcare, and to decrease the burden of multiple questionnaires, we propose focusing on patients' own perceptions of HRQoL in the clinical setting.


Assuntos
Fibromialgia/psicologia , Qualidade de Vida/psicologia , Adolescente , Experiências Adversas da Infância/estatística & dados numéricos , Criança , Dor Crônica/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Dor Musculoesquelética/psicologia , Estudos Retrospectivos
12.
Nutrients ; 11(5)2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31137906

RESUMO

The link between fibromyalgia syndrome (FMS) and obesity has not been thoroughly investigated. The purpose of this study was to examine the relationships among body mass index (BMI) and body composition parameters, including fat mass, fat mass percentage, and visceral fat, as well as FMS features, such as tender point count (TPC), pain, disease activity, fatigue, sleep quality, and anxiety, in a population of FMS women and healthy controls. A total of seventy-three women with FMS and seventy-three healthy controls, matched on weight, were included in this cross-sectional study. We used a body composition analyzer to measure fat mass, fat mass percentage, and visceral fat. Tender point count (TPC) was measured by algometry pressure. The disease severity was measured with the Fibromyalgia Impact Questionnaire (FIQ-R) and self-reported global pain was evaluated with the visual analog scale (VAS). To measure the quality of sleep, fatigue, and anxiety we used the Pittsburgh Sleep Quality Questionnaire (PSQI), the Spanish version of the multidimensional fatigue inventory (MFI), and the Beck Anxiety Inventory (BAI), respectively. Of the women in this study, 38.4% and 31.5% were overweight and obese, respectively. Significant differences in FIQ-R.1 (16.82 ± 6.86 vs. 20.66 ± 4.71, p = 0.030), FIQ-R.3 (35.20 ± 89.02 vs. 40.33 ± 5.60, p = 0.033), and FIQ-R total score (63.87 ± 19.12 vs. 75.94 ± 12.25, p = 0.017) among normal-weight and overweight FMS were observed. Linear analysis regression revealed significant associations between FIQ-R.2 (ß(95% CI)= 0.336, (0.027, 0.645), p = 0.034), FIQ-R.3 (ß(95% CI)= 0.235, (0.017, 0.453), p = 0.035), and FIQ-R total score (ß(95% CI)= 0.110, (0.010, 0.209), p = 0.032) and BMI in FMS women after adjusting for age and menopause status. Associations between sleep latency and fat mass percentage in FMS women (ß(95% CI)= 1.910, (0.078, 3.742), p = 0.041) and sleep quality and visceral fat in healthy women (ß(95% CI)= 2.614, (2.192, 3.036), p = 0.008) adjusted for covariates were also reported. The higher BMI values are associated with poor FIQ-R scores and overweight and obese women with FMS have higher symptom severity. The promotion of an optimal BMI might contribute to ameliorate some of the FMS symptoms.


Assuntos
Adiposidade , Ansiedade/fisiopatologia , Índice de Massa Corporal , Fadiga/fisiopatologia , Fibromialgia/fisiopatologia , Gordura Intra-Abdominal/fisiopatologia , Obesidade/fisiopatologia , Dor/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Sono , Idoso , Ansiedade/diagnóstico , Ansiedade/psicologia , Estudos de Casos e Controles , Estudos Transversais , Fadiga/diagnóstico , Fadiga/psicologia , Feminino , Fibromialgia/diagnóstico , Fibromialgia/psicologia , Humanos , Pessoa de Meia-Idade , Obesidade/diagnóstico , Dor/diagnóstico , Dor/psicologia , Fatores de Risco , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/psicologia
13.
Cuad. psicol. deporte ; 19(2): 52-69, mayo 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183269

RESUMO

El objetivo de este estudio fue analizar los efectos de un programa de danza española sobre el nivel sintomático, la capacidad funcional, diversas variables psicológicas y la composición corporal en una muestra de mujeres con fibromialgia. Un total de 43 mujeres de 45 a 70 años participaron en el estudio. Se utilizó un diseño intra-sujeto con medidas pre y post-test. Los instrumentos utilizados fueron la Escala Analógica Visual (VAS), el Cuestionario de Impacto de la Fibromialgia (FIQ), el Inventario de Depresión de Beck (BDI), el Inventario de Ansiedad Estado-Rasgo (STAI), la Escala Hamilton de Ansiedad (HARS), la Escala de Inteligencia Emocional (TMMS-24), el cuestionario Autoconcepto Forma 5 (AF5), el cuestionario de Perfil del Estado de Ánimo (POMS) y un bioimpediciómetro Tanita(R) BC-601. Los resultados mostraron efectos positivos después del programa, con mejoras en el estado de ánimo, la ansiedad psíquica y somática, así como la depresión


The objective of this study was to analyze the effects of a Spanish dance program on symptomatic level, functional capacity, psychological variables and body composition in a sample of women with fibromyalgia. A total of 43 women aged 45 to 70 years participated in the study. An intra-subject design with pre and post-test measurements was used. The instruments used were the Visual Analogue Scale (VAS), the Fibromyalgia Impact Questionnaire (FIQ), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Hamilton Anxiety Rating Scale (HARS), the Trait Meta-Mood Scale-24 (TMMS-24), the Self-concept form 5 questionnaire (AF5), the Profile of Mood States questionnaire (POMS) and a bioimpediciometer Tanita(R) BC-601. The results showed positive effects after the program, with improvements in mood, psychic and somatic anxiety, as well as depression


O objetivo deste estudo foi analisar os efeitos de um programa de dança espanhola no nível sintomático, capacidade funcional, diversas variáveis psicológicas e composição corporal em uma amostra de mulheres com fibromialgia. Um total de 43 mulheres com idade entre 45 e 70 anos participaram do estudo. Um desenho intra-sujeito foi usado com medições pré e pós-teste. Os instrumentos foram a Escala Analógica Visual (VAS), o Impact Questionnaire Fibromialgia (FIQ), o Beck Depression Inventory (BDI) Ansiedade Traço Estado Inventory (IDATE), Hamilton Anxiety Scale ( HARS), Escala de inteligência emocional (TMMS-24), o Autoconcepto Form 5 (AF5) questionário Mood States (POMS) Perfil questionário e bioimpediciómetro Tanita 2 BC-601. Os resultados mostraram efeitos positivos após o programa, com melhorias no humor, ansiedade e depressão psíquica e somática


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Dança/psicologia , Terapia através da Dança/métodos , Fibromialgia/terapia , Afeto , Ansiedade/psicologia , Dor Crônica/psicologia , Manejo da Dor/métodos , Fibromialgia/psicologia , Estudos Controlados Antes e Depois/estatística & dados numéricos , Resultado do Tratamento , Medição da Dor/métodos
14.
Int. j. clin. health psychol. (Internet) ; 19(2): 160-164, mayo 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184938

RESUMO

Background/Objective: The comorbidity of depression and fibromyalgia chronic syndrome has been well documented in the literature; however, the cognitive structure of these patients has not been assessed. Previous results reported variability in cognitive rigidity in depressive patients, the key for this might be the presence of chronic physical pain such as fibromyalgia. The present study explores and compares the cognitive rigidity and differentiation, between patients with depression with and without fibromyalgia syndrome. Method: Thirty one patients with depression and fibromyalgia were matched, considering age, sex and number of depressive episodes, with 31 patients with depression but without fibromyalgia diagnosis. Cognitive rigidity and differentiation were measured with the repertory grid technique. Results: The results indicated that depressed patients with fibromyalgia presented higher levels of depressive symptoms, greater cognitive rigidity and lower cognitive differentiation than those without fibromyalgia. Conclusions: The results might inform future treatments to address the cognitive structure of these patients


Antecedentes/Objetivo: La comorbilidad de la depresión y la fibromialgia ha sido bien documentada en la literatura. Sin embargo, la estructura cognitiva de estos pacientes no ha sido evaluada. Estudios previos muestran variabilidad en medidas de rigidez cognitiva en pacientes con depresión. Los síndromes físicos crónicos podrían ser una variable clave para explicar esta variabilidad presente en estudios previos. El presente estudio explora y compara la rigidez y la diferenciación cognitiva entre paciente con depresión que tienen y aquellos que no tienen fibromialgia. Método: Treinta y un pacientes con depresión y fibromialgia fueron emparejados, considerando edad, sexo y números de episodios depresivos con 31 pacientes con depresión, pero sin diagnóstico de fibromialgia. Resultados: Los resultados indican que los pacientes que presentan depresión y fibromialgia evidencian niveles más altos de síntomas depresivos, mayor rigidez cognitiva y menor diferenciación cognitiva que los pacientes sin fibromialgia. Conclusiones: Estos resultados podrían ser considerados al momento de crear tratamientos ajustados a la estructura cognitiva de estos pacientes


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fibromialgia/complicações , Fibromialgia/psicologia , Depressão/psicologia , Transtornos Cognitivos/psicologia , Estudos de Casos e Controles
15.
Braz J Psychiatry ; 41(5): 428-432, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30994852

RESUMO

OBJECTIVE: Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings. METHODS: This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student's t-tests. Correlations among parameters were performed. RESULTS: This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores. CONCLUSION: This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Fibromialgia/psicologia , Transtornos do Humor/psicologia , Temperamento , Adulto , Sintomas Afetivos/psicologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Projetos Piloto , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Inquéritos e Questionários
17.
Clin Exp Rheumatol ; 37 Suppl 116(1): 90-97, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30747096

RESUMO

Fibromyalgia syndrome (FM) is an enigma. During the past three decades, with the gradual acceptance of the validity of FM, it is variously under-, over and misdiagnosed. Evidence-based interdisciplinary guidelines have suggested a comprehensive clinical assessment to avoid this diagnostic conundrum. Every patient with chronic pain should be screened for chronic widespread pain (pain in four of five body regions) (CWP). Those with CWP should be screened for presence of additional major symptoms of FM: unrefreshed sleep and fatigue. A complete medical (including drug) history and complete physical examination is mandatory in the evaluation of a patient with CWP in order to consolidate the diagnosis of FM or identify features that may point to some other condition that may have a presentation similar to FM. Limited simple laboratory testing is recommended to screen for possible other diseases. The 2016 criteria may be used to further confirm the clinical diagnosis of FM. In consideration of the differential diagnosis of FM, attention should be paid to the presence of other chronic overlapping pain conditions and of mental disorders. FM as a stand alone diagnosis is however rare, as most patients with FM meet criteria for other chronic overlapping pain conditions or mental disorders. The severity of FM should be assessed in order to direct treatment approaches and help inform the likely outcome for an individual patient.


Assuntos
Dor Crônica , Fibromialgia/diagnóstico , Doença Crônica , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Diagnóstico Diferencial , Erros de Diagnóstico , Fadiga , Fibromialgia/psicologia , Humanos
18.
Clin Exp Rheumatol ; 37 Suppl 116(1): 105-113, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30747098

RESUMO

The concept of resilience varies according to the context in which it is used. Resilience is broadly defined as a protective factor that makes people less vulnerable to future adverse life events, in this implying the previous occurrence of an adverse event that has to be confronted before individual equilibrium can be restored. This definition can be applied to fibromyalgia and other chronic pain situations. Resilience is profoundly related to reaction to acute or chronic stress, and is therefore involved in the stress response system. Corticotropin-releasing factor can be considered a fundamental biological element of resilience, which also involves neural mechanisms such as the hypothalamic-pituitary-adrenal (HPA) axis, the locus coeruleus/norepinephrine system, the mesolimbic reward circuit and the fear circuit. Resilience also has a genetic basis: certain genetic characteristics, affect the degree of vulnerability to chronic stress. The number of psychiatric symptoms in healthy adults with high resilience scores do not change when they are exposed to stressing life events, whereas less resilient people develop additional symptoms. This is a typical clinical feature of fibromyalgia. Although resilience could be a therapeutic target for any chronic pain condition, it is an under-developed area of research, particularly in the light of the emerging interactions of positive emotions, physical health, and changes in pro-inflammatory cytokine levels. Given the lack of any pharmacological treatment capable of controlling more than 30-50% of the cases of chronic pain, there is a need to discover new therapeutic targets and strategies capable of changing a non-resilient phenotype into a more resilient phenotype, especially in the case of chronic pain conditions that cannot be explained by a lesion or a disease affecting the somatosensory system. This holds true of fibromyalgia, which is characterised by a complex combination of positive signs and symptoms that vary enormously from person to person depending on a wide range of pathophysiological changes in which genotype and, more importantly, environmental factors may play a major role in developing a more or less resilient personality.


Assuntos
Dor Crônica , Resiliência Psicológica , Adulto , Doença Crônica , Emoções , Fibromialgia/genética , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Predisposição Genética para Doença/genética , Predisposição Genética para Doença/psicologia , Humanos
19.
Clin Exp Rheumatol ; 37 Suppl 116(1): 98-104, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30747101

RESUMO

Although the mechanisms underlying fibromyalgia are not yet clear, many attempts have been made to implement pharmacological therapy and help patients manage its psychological and physical symptoms. Recent evidence has shown that an interdisciplinary multidimensional approach encompassing psychological factors, emotion regulation strategies and education on illness is more effective in improving quality of life, both in the short- and long-term, than usual treatments alone. The purpose of this review is to provide an updated overview of the available literature regarding the role of psychoeducation on fibromyalgia symptoms and health outcomes. We searched on PubMed Database with the keywords "fibromyalgia", "education" and "psychology" and then divided the results of our research into four main categories: effectiveness of psychoeducational programs versus treatment as usual, psychoeducational interventions versus other non-pharmacological treatments, Online-based education programs and specific characteristics of the participants. Our research highlighted that most of the considered studies found significant positive results on patients' condition, suggesting that an interdisciplinary intervention containing psychoeducation is an effective strategy in managing fibromyalgia symptoms.


Assuntos
Fibromialgia , Saúde Mental/educação , Educação de Pacientes como Assunto , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Qualidade de Vida
20.
Holist Nurs Pract ; 33(2): 111-120, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30747780

RESUMO

Despite the plethora of treatments available for patients with fibromyalgia, there is insufficient evidence to date as to what the ideal treatment approach is. This study sought to determine the effectiveness of a home program of audio-recorded guided imagery relaxation on people with fibromyalgia. This experimental 8-week longitudinal trial design was undertaken with 60 people diagnosed with fibromyalgia who were randomly assigned to either a guided imagery intervention group or a control group. Pain at tender points, anxiety, self-efficacy, quality of sleep, quality of life, and the impact of the fibromyalgia were determined at baseline, at 4 weeks, and at 8 weeks. After the guided imagery intervention, we found significant differences regarding trait anxiety, sleep quality, and tenderness at some of the tender points. There is a need, therefore, to develop and evaluate interventions that may enhance the quality of life of those affected by this disorder.


Assuntos
Fibromialgia/terapia , Terapia de Relaxamento/métodos , Ansiedade/psicologia , Ansiedade/terapia , Feminino , Fibromialgia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Terapia de Relaxamento/tendências , Autoeficácia , Transtornos do Sono-Vigília/psicologia , Transtornos do Sono-Vigília/terapia , Inquéritos e Questionários , Gravação de Fita/métodos , Gravação de Fita/normas , Resultado do Tratamento
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