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1.
Med Clin North Am ; 105(2): 285-296, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33589103

RESUMO

Fibromyalgia is a chronic pain condition manifested by chronic generalized pain, fatigue, disordered sleep, and cognitive difficulties, persistent for at least 3 months. Other common complaints/conditions include symptoms of irritable bowel syndrome, headaches, intermittent paresthesias, and various mood disorders. Women are more commonly affected than men. The treatment approach should be individualized and focused on associated mood disorders, sleep, exercise, correction of maladaptive responses to pain, and coping with stress.


Assuntos
Fibromialgia , Administração dos Cuidados ao Paciente/métodos , Atenção Primária à Saúde/métodos , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos
2.
Trials ; 22(1): 104, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514408

RESUMO

BACKGROUND: Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), combined with a non-invasive brain stimulation technique, such as multifocal transcranial current stimulation (MtCS), could be an innovative adjunctive treatment option. This double-blind randomized controlled trial (RCT) analyzes if EMDR therapy is effective in the reduction of pain symptoms in FM patients and if its potential is boosted with the addition of MtCS. METHODS: Forty-five patients with FM and a history of traumatic events will be randomly allocated to Waiting List, EMDR + active-MtCS, or EMDR + sham-MtCS. Therapists and patients will be kept blind to MtCS conditions, and raters will be kept blind to both EMDR and MtCS. All patients will be evaluated at baseline, post-treatment, and follow-up at 6 months after post-treatment. Evaluations will assess the following variables: sociodemographic data, pain, psychological trauma, sleep disturbance, anxiety and affective symptoms, and wellbeing. DISCUSSION: This study will provide evidence of whether EMDR therapy is effective in reducing pain symptoms in FM patients, and whether the effect of EMDR can be enhanced by MtCS. TRIAL REGISTRATION: ClinicalTrials.gov NCT04084795 . Registered on 2 August 2019.


Assuntos
Dessensibilização e Reprocessamento através dos Movimentos Oculares , Fibromialgia/terapia , Trauma Psicológico/psicologia , Estimulação Transcraniana por Corrente Contínua , Dor Crônica , Método Duplo-Cego , Fibromialgia/psicologia , Humanos , Ensaios Clínicos Pragmáticos como Assunto , Qualidade de Vida , Resultado do Tratamento , Listas de Espera
3.
PLoS One ; 15(12): e0243806, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370324

RESUMO

BACKGROUND: Coping strategies and their efficacy vary greatly in patients suffering from fibromyalgia syndrome (FMS). OBJECTIVE: We aimed to identify somatic and psychosocial factors that might contribute to different coping strategies and resilience levels in FMS. SUBJECTS AND METHODS: Standardized questionnaires were used to assess coping, pain, and psychological variables in a cohort of 156 FMS patients. Quantitative real-time polymerase chain reaction (qRT-PCR) determined gene expression of selected cytokines in white blood cells of 136 FMS patients and 25 healthy controls. Data of skin innervation, functional and structural sensory profiles of peripheral nociceptive nerve fibers of a previous study were included into the statistics. An exploratory factor analysis was used to define variance explaining factors, which were then included into cluster analysis. RESULTS: 54.9% of the variance was explained by four factors which we termed (1) affective load, (2) coping, (3) pain, and (4) pro-inflammatory cytokines (p < 0.05). Considering differences in the emerged factors, coping strategies, cytokine profiles, and disability levels, 118 FMS patients could be categorized into four clusters which we named "maladaptive", "adaptive", "vulnerable", and "resilient" (p < 0.05). The adaptive cluster had low scores in disability and in all symptom categories in contrast to the vulnerable cluster, which was characterized by high scores in catastrophizing and disability (p < 0.05). The resilient vs. the maladaptive cluster was characterized by better coping and a less pro-inflammatory cytokine pattern (p < 0.05). CONCLUSION: Our data suggest that problem- and emotion-focused coping strategies and an anti-inflammatory cytokine pattern are associated with reduced disability and might promote resilience. Additional personal factors such as low anxiety scores, ability of acceptance, and persistence further favor a resilient phenotype. Individualized therapy should take these factors into account.


Assuntos
Adaptação Psicológica , Fibromialgia/psicologia , Análise por Conglomerados , Citocinas/sangue , Feminino , Fibromialgia/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
4.
PLoS One ; 15(9): e0239286, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941517

RESUMO

BACKGROUND: MicroRNA (miRNA) mainly inhibit post-transcriptional gene expression of specific targets and may modulate disease severity. OBJECTIVE: We aimed to identify miRNA signatures distinguishing patient clusters with fibromyalgia syndrome (FMS). SUBJECTS AND METHODS: We previously determined four FMS patient clusters labelled "maladaptive", "adaptive", "vulnerable", and "resilient". Here, we cluster-wise assessed relative gene expression of miR103a-3p, miR107, miR130a-3p, and miR125a-5p in white blood cell (WBC) RNA of 31 FMS patients and 16 healthy controls. Sum scores of pain-, stress-, and resilience-related questionnaires were correlated with miRNA relative gene expression. A cluster-specific speculative model of a miRNA-mediated regulatory cycle was proposed, and its potential targets verified by the online tool "target scan human". RESULTS: One-way ANOVA revealed lower gene expression of miR103a-3p, miR107, and miR130a-3p in FMS patients compared to controls (p < 0.05). Follow-up post-hoc tests indicated the highest peak of gene expression of miR103a-3p for the adaptive cluster (p < 0.05), i.e. in patients with low disability in all symptom categories. Gene expression of miR103a-3p correlated with FMS related disability and miR107 with the score "physical abuse" of the trauma questionnaire (p < 0.05). Target scan identified sucrose non-fermentable serine/threonine protein kinase, nuclear factor kappa-b, cyclin dependent kinase, and toll-like receptor 4 as genetic targets of the miR103a/107 miRNA family. CONCLUSION: We show an association between upregulated gene expression of miR103a, tendentially of miR107, and adaptive coping in FMS patients. Validation of this pair of miRNA may enable to identify a somatic resilience factor in FMS.


Assuntos
Adaptação Psicológica , Fibromialgia/genética , MicroRNAs/genética , Resiliência Psicológica , Feminino , Fibromialgia/psicologia , Humanos , Masculino , MicroRNAs/metabolismo , Pessoa de Meia-Idade , Regulação para Cima
5.
Pain Res Manag ; 2020: 3408052, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32714478

RESUMO

Objective: To provide a brief and comprehensive summary of the recent evidence from clinical trials testing psychotherapeutic interventions in patients with fibromyalgia with particular interest in their possible effect on physical pain. Methods: Bibliographical search was performed in PubMed, PsycInfo, Web of Science, Scopus, and Cochrane Library databases. Content of the manuscripts was studied to obtain, if available, the following information: year of publication, location of the research team, design, type of psychotherapeutic intervention tested, pain measures, and a brief description of the psychotherapy, groups, and outcomes regarding physical pain. Results: Initial search eliciting 475 citations got reduced to 13 relevant papers. Most research studies from Spain (n = 8) are randomized control trials (n = 10) and used guided imagery (n = 5) or cognitive behavioral therapy (n = 4). The Visual Analogue Scale (n = 4) and the Fibromyalgia Impact Questionnaire (n = 4) were the physical pain measures mostly used. Improvements on physical pain were reported on all studies with published results; nevertheless, only in five cases, differences were significant. Conclusions: Evidence on the effect of psychotherapy on physical pain in patients with FS was divergent; though most studies report a reduction in pain, this was not always lasting and/or significant. Diversity of the results might be due to the selected psychotherapeutic approaches, assessment tools, and other internal (e.g., personality traits, (sub)clinical psychiatric symptoms, and treatment adherence) and external (e.g., family environment and social support) variables worth to be considered in the future research.


Assuntos
Fibromialgia/psicologia , Fibromialgia/terapia , Psicoterapia/métodos , Dor Crônica/etiologia , Dor Crônica/psicologia , Dor Crônica/terapia , Humanos , Espanha
6.
Pain Physician ; 23(4): E353-E362, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32709181

RESUMO

BACKGROUND: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. OBJECTIVES: The aim of this study was to compare the area and intensity of pressure-induced referred pain in patients with FM as elicited by systematic increases in PPTs, compared with controls. STUDY DESIGN: Observational, crossed-section study. SETTING: Research laboratory. METHODS: Twenty-six patients with FM and 26 healthy controls, age- and gender-matched, were included. Suprathreshold stimulation was applied to the infraspinatus muscle of the dominant side at 4 different intensities (PPT +20%, +30%, +40%, and +50%), after which referred pain was evaluated by measuring the area of pain in pixels using a digital body chart and its intensity on a Visual Analog Scale. Factors related to anxiety condition, pain catastrophizing, depression, and quality of life were recorded. RESULTS: The referred pain areas were larger in the FM group compared with healthy individuals at 120% (P = 0.024), 130% (P = 0.001), 140% (P = 0.001), and 150% (P = 0.001) PPT, however, within the FM group no differences were found between the intensity of suprathreshold stimulation and the size of the referred pain areas (P = 0.135) or pain intensity (P > 0.05). There was a positive correlation between the size of referred pain areas and pain catastrophizing in the FM group (r = 0.457, P = 0.032). LIMITATIONS: This study presents some limitations, among which is the variability found in the referred pain areas. CONCLUSIONS: These findings show that referred pain induced by applying a suprathreshold pressure of 120% PPT can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from FM. KEY WORDS: Referred pain, pain sensitivity, fibromyalgia, central sensitization, suprathreshold, pressure pain threshold, biomarker, facilitated pain mechanisms.


Assuntos
Fibromialgia/diagnóstico , Fibromialgia/psicologia , Medição da Dor/métodos , Limiar da Dor/psicologia , Dor Referida/diagnóstico , Dor Referida/psicologia , Adulto , Idoso , Catastrofização/diagnóstico , Catastrofização/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limiar da Dor/fisiologia , Qualidade de Vida/psicologia , Adulto Jovem
7.
Medicine (Baltimore) ; 99(21): e20257, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481303

RESUMO

BACKGROUND: Fibromyalgia (FM) is a common chronic pain condition that seriously affects the quality of patient lives. Its etiology, pathogenesis, and treatment still remain uncertain. Dietary supplements have been widely trialed for symptom relief for FM. The review aims to synthesize the previous literature publications to assess the impact of herbs and dietary supplements on FM patients. METHODS: We will conduct a literature search in the following databases PubMed, MEDLINE, EMBASE, Cochrane Library, Scopus, and Global Health from database inception to December 2019. Clinical studies published in the English language that used human participants and address the efficacy, safety, and acceptability of herbs and dietary supplements on individuals with FM will be included. The risk of bias and quality assessment of each trial will be evaluated. If trials are enough, a meta-analysis will be conducted using software RevMan5.3, Cochrane Collaboration. RESULT: Our review will be the first attempt to facilitate evidence-based management using herbs and dietary supplements to treat patients with FM. CONCLUSION: The findings may provide a framework for future research and clinic practice in FM management. PROSPERO REGISTRATION NUMBER: CRD42020149941.


Assuntos
Suplementos Nutricionais/efeitos adversos , Fibromialgia/terapia , Plantas Medicinais/efeitos adversos , Doença Crônica , Estudos de Avaliação como Assunto , Feminino , Fibromialgia/epidemiologia , Fibromialgia/psicologia , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança
8.
Inf. psiquiátr ; (240): 27-42, abr.-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194756

RESUMO

La fibromialgia afecta en gran medida a la calidad de vida de las personas que la sufren, así como a su funcionalidad, especialmente si la persona presenta síntomas comórbidos de ansiedad y/o depresión, lo que resalta la importancia del tratamiento psicológico. El objetivo del presente trabajo es comparar la eficacia de dos tratamientos cognitivo-conductuales breves en personas con diagnóstico de fibromialgia y con afectación emocional. Participaron un total de 44 personas (42 mujeres y 2 hombres) divididos en dos grupos de tratamiento: uno de ellos elaborado únicamente con componentes convencionales de la terapia cognitivo-conductual (grupo A) y el otro con los mismos componentes más un componente añadido de expresión emocional a través del dibujo (grupo B). Se encontraron puntuaciones significativamente mejores (p < 0,05) después de aplicar cualquiera de los dos tratamientos en las siguientes áreas: funcionalidad, percepción del dolor, ansiedad, depresión, catastrofismo, miedo al movimiento, estrategias de afrontamiento activo y percepción de autoeficacia. Se concluye que los resultados obtenidos apoyan la eficacia de ambos tratamientos cognitivo conductuales para personas con fibromialgia y afectación emocional


Fibromyalgia largely affects the life quality of people suffering from it, as well as its functionality, especially if the person has comorbid symptoms of anxiety and/or depression, which highlights the importance of psychological treatment. The objective of this study is to compare the efficacy of two brief cognitive-behavioral treatments in people with a fibromyalgia diagnosis and emotional involvement. A total of 44 people enrolled in the study (42 female, 2 male), divided within two treatment groups: one of them made only with conventional components of cognitive-behavioral therapy (group A) and the other with the same components plus an added component of emotional expression through drawing (group B). Significantly better scores were found (p < 0.05) after applying any of the two treatments in the following areas: functionality, pain perception, anxiety, depression, catastrophism, fear of movement, active coping strategies and self-efficacy perception. It is concluded that the results obtained support the efficacy of both cognitive-behavioral treatments for people with fibromyalgia and emotional involvement


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Fibromialgia/psicologia , Terapia Cognitivo-Comportamental/métodos , Resultado do Tratamento , Qualidade de Vida/psicologia , Terapia Focada em Emoções/métodos , Ansiedade/psicologia , Depressão/psicologia , Fibromialgia/diagnóstico , Inquéritos e Questionários , Medição da Dor/métodos , Escalas de Graduação Psiquiátrica Breve , Terapia de Relaxamento , Adaptação Psicológica , Análise de Variância
9.
Artigo em Inglês | MEDLINE | ID: mdl-32466421

RESUMO

The aim of this review was to demonstrate the presence of categories and subcategories of Mishel's model in the experiences of patients with fibromyalgia by reviewing qualitative studies. Uncertainty is defined as the inability to determine the meaning of disease-related events. A scoping review of qualitative studies was carried out. Twenty articles were included, with sample sizes ranging from 3 to 58 patients. Articles from different countries and continents were included. Three categories of the model and eight subcategories could be shown to be present in the experiences of fibromyalgia patients through the scoping review. The first category, concerning antecedents of uncertainty in patients with fibromyalgia, is constituted by the difficulty in coping with symptoms, uncertainty about the diagnosis and uncertainty about the complexity of the treatment. The second concerns the cognitive process of anxiety, stress, emotional disorder and social stigma. The third category refers to coping with the disease, through the management of social and family support and the relationship with health care professionals.


Assuntos
Adaptação Psicológica , Fibromialgia , Incerteza , Ansiedade , Feminino , Fibromialgia/psicologia , Humanos , Masculino , África do Sul
10.
Artigo em Inglês | MEDLINE | ID: mdl-32455853

RESUMO

Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain and other physical and psychological features. In this study, we aimed to analyze the effect of a low-intensity physical exercise (PE) program, combining endurance training and coordination, on psychological aspects (i.e., pain catastrophizing, anxiety, depression, stress), pain perception (i.e., pain acceptance, pressure pain threshold (PPT), and quality of life and physical conditioning (i.e., self-perceived functional capacity, endurance and functional capacity, power and velocity) in women with FM. For this purpose, a randomized controlled trial was carried out. Thirty-two women with FM were randomly allocated to a PE group (PEG, n = 16), performing an eight-week low-intensity PE program and a control group (CG, n = 16). Pain catastrophizing, anxiety, depression, stress, pain acceptance, PPT, quality of life, self-perceived functional capacity, endurance and functional capacity, power, and velocity were assessed before and after the intervention. We observed a significant improvement in all studied variables in the PEG after the intervention (p < 0.05). In contrast, the CG showed no improvements in any variable, which further displayed poorer values for PPT (p < 0.05). In conclusion, a low-intensity combined PE program, including endurance training and coordination, improves psychological variables, pain perception, quality of life, and physical conditioning in women with FM.


Assuntos
Catastrofização , Terapia por Exercício/métodos , Exercício Físico , Fibromialgia/psicologia , Fibromialgia/terapia , Qualidade de Vida/psicologia , Treinamento de Resistência/métodos , Ansiedade , Depressão , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Fibromialgia/reabilitação , Humanos , Dor , Estresse Psicológico , Resultado do Tratamento
11.
Artigo em Inglês | MEDLINE | ID: mdl-32224987

RESUMO

Anxiety, mood disturbance, eating and sleep disorders, and dissatisfaction with body image are prevalent disorders in women with fibromyalgia. The authors of this study aimed to determine the effects of tryptophan (TRY) and magnesium-enriched (MG) Mediterranean diet on psychological variables (trait anxiety, mood state, eating disorders, self-image perception) and sleep quality in women with fibromyalgia (n = 22; 49 ± 5 years old). In this randomized, controlled trial, the participants were randomly assigned to the experimental group and the placebo group. The intervention group received a Mediterranean diet enriched with high doses of TRY and MG (60 mg of TRY and 60 mg of MG), whereas the control group received the standard Mediterranean diet. Pittsburgh Sleep Quality Questionnaire, Body Shape Questionnaire, State-Trait Anxiety Inventory (STAI), Profile of Mood States (POMS-29) Questionnaire, Eating Attitudes Test-26, and Trait Anxiety Inventory were completed before and 16 weeks after the intervention. Significant differences were observed between groups after the intervention for the mean scores of trait anxiety (p = 0.001), self-image perception (p = 0.029), mood disturbance (p = 0.001), and eating disorders (p = 0.006). This study concludes that tryptophan and magnesium-enriched Mediterranean diet reduced anxiety symptoms, mood disturbance, eating disorders, and dissatisfaction with body image but did not improve sleep quality in women with fibromyalgia.


Assuntos
Ansiedade/tratamento farmacológico , Dieta Mediterrânea , Fibromialgia/psicologia , Magnésio/uso terapêutico , Sono/efeitos dos fármacos , Triptofano/uso terapêutico , Adulto , Feminino , Humanos , Pessoa de Meia-Idade
12.
J Psychosom Res ; 133: 110111, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32305723

RESUMO

OBJECTIVE: To study the prevalence and clinical characteristics of Somatic Symptom Disorder (SSD), Bodily Distress Syndrome (BDS) and fibromyalgia syndrome (FMS) and their overlap in the general German population. METHODS: A cross-sectional nationally representative population survey was performed. 2531 participants (mean age 48.8 ±â€¯17.85 years, 53.3% women) completed the Somatic Symptom Scale SSS-8, the Bodily Distress Syndrome (BDS) 25 checklist, the Whiteley Index 7 (WI-7), the self-administered comorbidity questionnaire and the Michigan Body Map. Case definitions of SSD, BDS and FMS were assigned using established criteria. RESULTS: 4.5% of participants met the criteria of SSD (SSS - 8 at least one item "bothered very much" and WI- 7 total score ≥ 1). 9.6% met the criteria of single-organ BDS and 1.3% of multi-organ BDS. Prevalence of FMS according to 2016 criteria was 3.4%. 82.3% of FMS cases met any BDS criteria.28.1% of FMS cases satisfied SSD criteria. 28.8% of any BDS cases met the criteria of SSD. 75.1% of SSD cases met the criteria of any BDS. FMS cases reported the highest amount of somatic and psychological symptom burden and health anxieties. There were no differences in age and gender between any BDS and SSD cases. SSD cases reported worse general health and more fibromyalgia-related variables than any BDS cases. CONCLUSIONS: In the general population, there is a substantial overlap between FMS and BDS, but not of FMS and SSD, and not of SSD and any BDS. Case definitions of the three disorders partially captured different groups in the general population.


Assuntos
Fibromialgia/epidemiologia , Sintomas Inexplicáveis , Adulto , Idoso , Ansiedade/psicologia , Estudos Transversais , Feminino , Fibromialgia/psicologia , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
13.
PLoS One ; 15(4): e0231674, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287311

RESUMO

OBJECTIVES: Fibromyalgia (FM) is a chronic pain syndrome, and alexithymia, which is a condition that is characterised by deficits in emotional self-awareness, is highly prevalent among individuals with FM. Insecure attachment styles and inadequate parental care appear to play an important role in the onset and maintenance of both alexithymia and chronic pain. Therefore, the present study aimed to examine the associations between attachment styles, parental bonding, and alexithymia among patients with FM and healthy controls (HC). METHODS: All participants completed a battery of tests that assessed alexithymia, attachment styles, and parental bonding. Two logistic regression models were tested to examine whether these variables predict (a) group membership (i.e. patients with FM vs. HC) and (b) the likelihood of having alexithymia (i.e. among patients with FM and HC). RESULTS: Alexithymia (i.e. difficulty identifying and describing feelings subscales of the 20-item Toronto Alexithymia Scale) significantly predicted group membership (i.e. the likelihood of having FM). On the other hand, educational level and dismissive attachment (i.e. the discomfort with closeness and relationships as secondary subscales of the Attachment Style Questionnaire) were the only significant predictors of the likelihood of having alexithymia. CONCLUSIONS: These findings highlight both the relevance of alexithymic traits to the definition of FM and centrality of an insecure attachment style to the manifestation of alexithymia.


Assuntos
Sintomas Afetivos/psicologia , Fibromialgia/psicologia , Apego ao Objeto , Poder Familiar/psicologia , Adulto , Sintomas Afetivos/epidemiologia , Idoso , Feminino , Fibromialgia/epidemiologia , Humanos , Comportamento Materno/psicologia , Pessoa de Meia-Idade
14.
Clin Exp Rheumatol ; 38 Suppl 123(1): 79-85, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116214

RESUMO

OBJECTIVES: Forgiveness influences health through numerous mechanisms, but commonly it is thought to reduce stress, increase healthy behaviour, and promote social support, thereby positively impacting health and wellbeing. Self-forgiveness has been given considerable attention in relation to health and wellbeing. Fibromyalgia (FM) patients had lower forgiveness of others and self-forgiveness as compared to controls. The aim of this study is to explore the relationship of self-forgiveness (FS) with the impact and severity of FM, acceptance, catastrophising, and coping. METHODS: We evaluated 228 FM female patients who completed the Mauger Forgiveness Scale, the Combined Index of Severity in Fibromyalgia (ICAF) survey, the Chronic Pain Acceptance Questionnaire (CPAQ), and the Pain Catastrophising Scale (PCS). RESULTS: High self-forgiveness is related to high levels of active coping (r=.41) and acceptation (r=.38), and low self-forgiveness is related to emotional negative factors and catastrophising (r=-.56). Two factors (physical and emotional) were obtained. Lower FS is an emotional factor with negative emotion, catastrophising and a deficit in active coping. A decision-tree analysis showed a first node with ICAF Emotional scores and a second level with CPAQ and PCS scores as predictors. CONCLUSIONS: A notable lack of FS indicates a problem (distress and catastrophising) with the health aspects related to this syndrome. Acceptance could require a low negative emotional status. People with high FS were likely to increase acceptation as the positive component of acceptance in FS. This finding does not indicate an interest in maintaining problematic behaviours.


Assuntos
Adaptação Psicológica , Catastrofização , Dor Crônica/psicologia , Fibromialgia/psicologia , Perdão , Feminino , Humanos , Inquéritos e Questionários
15.
Qual Life Res ; 29(7): 1871-1881, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32112278

RESUMO

BACKGROUND: Patients with fibromyalgia syndrome (FMS) usually display a decrease in health-related quality of life (HRQoL). This decrease in HRQoL is related to clinical pain, anxiety, and depression. This cross-sectional study analyzes the mediating role of pain-coping strategies (especially catastrophizing) in the negative relationships of pain, anxiety, depression, and HRQoL in FMS. METHODS: One hundred and thirteen women with FMS and 63 healthy women were assessed using the Short-Form Health Survey (SF-36). Participants completed self-report questionnaires to evaluate clinical pain, anxiety, depression, and pain-coping strategies. RESULTS: Pain catastrophizing was inversely associated with the physical function, general health perception, vitality, emotional role, mental health, the physical and mental general components, and the global index of HRQoL, with percentages of variance explained ranging between 9 and 18%. Cognitive distraction showed a positive association with the physical function, general health perception, vitality, emotional role, mental health, physical component, and global index of HRQoL, with percentages of variance explained ranging between 4 and 7%. Mediation analysis showed that catastrophizing mediates the negative influence of clinical pain and trait-anxiety on the physical function, general health perception, vitality, mental health, and global index of HRQoL. No mediating effect of pain catastrophizing on the relation between depression and HRQoL was observed. CONCLUSIONS: Patients with FMS exhibited markedly lower HRQoL than healthy individuals. While pain catastrophizing was inversely related to several domains of HRQL, associations were positive for cognitive distraction. Catastrophizing mediates the negative influence of clinical pain and trait-anxiety on HRQoL. Therefore, cognitive behavioral treatments focused on adaptive management and control of catastrophizing and negative emotional states may be helpful.


Assuntos
Catastrofização/psicologia , Fibromialgia/psicologia , Manejo da Dor/psicologia , Dor/psicologia , Qualidade de Vida/psicologia , Adaptação Psicológica , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Estudos Transversais , Depressão/psicologia , Emoções , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Manejo da Dor/métodos , Autorrelato , Inquéritos e Questionários
16.
Med Sci Sports Exerc ; 52(7): 1617-1628, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32168104

RESUMO

PURPOSE: Physical exercise is increasingly being promoted by health care for chronic pain conditions with beneficial outcomes, such as pain and fatigue reduction, and increased quality of life. Nevertheless, knowledge about biochemical consequences of physical exercise in chronic pain is still relatively poor. The endocannabinoid system has been suggested to play a role for acute exercise-induced reward and pain inhibition. The aim of this study is to investigate the chronic outcomes of resistance exercise on levels of endocannabinoids and related lipids in fibromyalgia (FM). METHODS: This study examine the outcomes of a 15-wk person-centered resistance exercise program on plasma levels of the lipid mediators; anandamide, 2-arachidonoylglycerol (2-AG), oleoylethanolamide, palmitoylethanolamide, and stearoylethanolamide (SEA) sampled from 37 women with FM and 33 healthy controls. The associations between clinical scorings of pain, depression, anxiety, fatigue, and muscle strength with levels of these lipid mediators before and after the exercise program are also analyzed. RESULTS: After the 15-wk exercise program, anandamide levels were significantly increased, and SEA levels significantly decreased in FM. Pain intensity and depression scorings decreased and muscle strength increased, and in a multivariate context, muscle strength was positively associated with 2-AG levels after the resistance exercise program in FM. CONCLUSIONS: The increased anandamide and decreased SEA in women with FM after the 15-wk program might point to a chronic effect of resistance exercise. Pain and depression scorings decreased in the FM group after the program, but no associations between pain, depression, and lipid level changes were assured.


Assuntos
Ácidos Araquidônicos/sangue , Depressão/terapia , Endocanabinoides/sangue , Terapia por Exercício/métodos , Fibromialgia/sangue , Fibromialgia/terapia , Manejo da Dor , Alcamidas Poli-Insaturadas/sangue , Treinamento de Resistência , Amidas , Ansiedade/terapia , Etanolaminas/sangue , Fadiga/terapia , Feminino , Fibromialgia/psicologia , Glicerídeos/sangue , Humanos , Ácidos Oleicos/sangue , Ácidos Palmíticos/sangue , Ácidos Esteáricos/sangue
17.
Ann Intern Med ; 172(5): ITC33-ITC48, 2020 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-32120395

RESUMO

Fibromyalgia is characterized by chronic, widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. For many patients, these symptoms persist for years and lead to frequent health care use; for some, fibromyalgia and its symptoms can be debilitating. Although many treatments are available, management remains challenging. This article highlights the clinical features of fibromyalgia, discusses diagnostic criteria and their evolution, and reviews treatment options.


Assuntos
Fibromialgia , Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Prognóstico , Encaminhamento e Consulta , Fatores de Risco
18.
Clin Exp Rheumatol ; 38 Suppl 123(1): 40-46, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31928594

RESUMO

OBJECTIVES: Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with other symptoms, including psychological distress. While negative mood (anxiety, depression, and anger) has been widely explored in FM, few studies have investigated emotional dysregulation. Our purpose was to evaluate problems in the processes of emotional regulation and to explore their influence on the severity of pain and disability. METHODS: Emotional regulations, anxiety, depression, anger, pain and disability were evaluated in 47 FM patients and 47 healthy subjects. Regression analyses were performed to evaluate the role that emotional regulation processes have on pain severity and disability of FM patients. RESULTS: Results showed that although FM patients do not differ in terms of the attention paid to their emotional states, FM patients had greater difficulties in the emotional regulation process. In addition, emotional rejection and interference are two variables that influence the pain severity and disability. CONCLUSIONS: FM patients need to be trained in strategies for regulating their emotions, in order to achieve a reduction in negative mood states, as well as their impact in pain and disability.


Assuntos
Regulação Emocional , Fibromialgia/psicologia , Dor/psicologia , Ira , Ansiedade , Depressão , Avaliação da Deficiência , Fibromialgia/fisiopatologia , Humanos , Dor/fisiopatologia
19.
Rev Esp Salud Publica ; 942020 Jan 10.
Artigo em Espanhol | MEDLINE | ID: mdl-31919340

RESUMO

OBJECTIVE: The clinical approach of fibromyalgia is a cause of frustration for some professionals due to the controversy on its diagnosis, etiopathology and clinical management. The aim of this study was to explore the beliefs and knowledge on fibromyalgia among health professionals from different specialties of the public health service from Almería province. METHODS: A descriptive and cross-sectional study was carried out. A questionnaire prepared ex profeso was applied to a sample of 103 clinicians from Primary Care Physicians, Mental Health, Internal Medicine and Rheumatology. The chi-square test was performed to explore the relationships among variables. RESULTS: 59.7% of Primary Care providers and 66.7% of Internal Medicine conceptualized fibromyalgia as a somatization. Likewise, 58.9% of Primary Care indicated that fibromyalgia should be considered in no case as a disabling illness, compared to 16.7% from Rheumatology, as well as for 42.5% of them the fibromyalgia diagnosis is not essential, compared to the amount of other specialties. Mood disorders were mentioned by 53.4% of Primary Care as entities from which fibromyalgia is difficult to discriminate. Sleep or gastrointestinal problems were mentioned by 83.3% and 50% of Rheumatology professionals, respectively. CONCLUSIONS: A high percentage of professionals considered fibromyalgia as a psychogenic entity, especially among Internal Medicine and Primary Care, highlighting in the last one a position against the consideration of disability and its difficult differentiation from mood disorders. These latest findings could be explained by beliefs or attitudes on the amplification of pain behaviors and secondary gains. A deeper knowledge on fibromyalgia symptoms from Rheumatology is highlighted. Methodological limitations and recommendations are discussed.


Assuntos
Atitude do Pessoal de Saúde , Consenso , Dissidências e Disputas , Fibromialgia , Adulto , Estudos Transversais , Feminino , Fibromialgia/diagnóstico , Fibromialgia/etiologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Medicina Interna , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Reumatologia , Espanha , Inquéritos e Questionários
20.
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
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