Acceptance, Cognitive-Behavioural and Mindfulness-Based Psychological Interventions for Fibromyalgia: A Systematic Review

Main Article Content

Seán Heagney, MSc Nicola Adams, PhD

Abstract

Objective: To analyse the effectiveness of cognitive-behaviour therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR), for treating symptoms of fibromyalgia.


Methods: PubMed, Cochrane and Science Direct electronic libraries were searched (from January 2015 to October 2023). Randomised controlled trials (RCTs), of CBT, ACT, and MBSR-based interventions for pain intensity, pain catastrophising, depression, anxiety, sleep quality, fatigue and health-related quality of life in people diagnosed with fibromyalgia were considered. Studies were selected and data was extracted by two independent reviewers using the Template for Intervention Description and Replication (TIDieR) checklist, while quality appraisals of the evidence was also conducted using the Physiotherapy Evidence Database and Cochrane Risk of Bias  version 2 tools.


Results: Seven RCTs (n = 730 participants) were analysed. CBT was associated with improved pain intensity, sleep quality and quality of life, but not fatigue and uncertain for depression. MBSR reduced depression and anxiety and enhanced quality of life scores. Improvements in pain intensity, depression and quality of life were demonstrated with digital ACT, with superior participant adherence versus other face-to-face interventions. Considerable heterogeneity of interventions was apparent. The evidence for all interventions was equivocal with four studies deemed ‘high risk’ of bias and three with ‘some concerns’ following quality appraisal.


Conclusion: Cognitive-behaviour therapy, acceptance and commitment therapy and mindfulness based stress reduction demonstrate mostly small effects on fibromyalgia symptoms in favour of the intervention. However, when delivered in digital therapy format, these shows promise as a means of enhancing patient adherence to treatment, and potentially accelerating access to care with subsequent reduction of burden on waiting lists for health care providers.

Keywords: Cognitive-behaviour therapy, acceptance and commitment therapy, mindfulness-based stress reduction, fibromyalgia, pain, quality of life

Article Details

How to Cite
HEAGNEY, Seán; ADAMS, Nicola. Acceptance, Cognitive-Behavioural and Mindfulness-Based Psychological Interventions for Fibromyalgia: A Systematic Review. Medical Research Archives, [S.l.], v. 12, n. 7, july 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5242>. Date accessed: 07 dec. 2024. doi: https://doi.org/10.18103/mra.v12i7.5242.
Section
Review Articles

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