Psychological treatments for fibromyalgia: A meta-analysis
Psychological treatments for fibromyalgia: A meta-analysis
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DOI：
10.1016/j.pain.2010.06.011
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发表时间：
2010-11-01
期刊：
影响因子：
7.4
通讯作者：
Hofmann, Stefan G.
中科院分区：
文献类型：
--
作者：
Glombiewski, Julia A.;Sawyer, Alice T.;Hofmann, Stefan G.
目前分析的目的是调查心理干预对纤维肌痛的短期和长期疗效和治疗调节剂。使用PubMed、心理学信息、Cochrane图书馆和手动搜索进行的文献搜索确定了23项符合条件的研究，包括30项心理治疗条件和1396名患者。在所有心理干预的平均7.4个月的随访期中，Meta分析整合导致了短期疼痛减轻的显著但较小的效应(Hgees‘s g=0.37，95%可信区间(CI)：0.27-0.48)和对长期疼痛缓解的中小效应(Hgees’s g=0.47，95%CI：0.3-0.65)。心理治疗对减少睡眠问题(赫奇斯的g=0.46，95%CI：0.28~0.64)、抑郁(赫奇斯的g=0.33，95%CI：0.20~0.45)、功能状态(赫奇斯的g=0.42，95%CI：0.25~0.58)和灾难(赫奇斯的g=0.33，95%CI：0.17~0.49)也有效。这些效果在随访时保持稳定。主持人分析显示，认知-行为疗法在短期疼痛缓解方面明显优于其他心理疗法(赫奇斯的g=0.60，95%CI：0.46-0.76)。治疗剂量越大，结果越好。发表偏倚分析表明，效应大小是稳健的。结果表明，心理治疗对纤维肌痛的影响相对较小，但强大，与报道的其他疼痛和用于这种疾病的药物治疗的效果相当。认知-行为疗法与最大的效果大小相关。(C)2010年国际疼痛研究协会。爱思唯尔出版公司版权所有。
The aims of the present analysis were to investigate the short-and long-term efficacies and treatment moderators of psychological interventions for fibromyalgia. A literature search using PubMed, PsychINFO, the Cochrane Library, and manual searches identified 23 eligible studies including 30 psychological treatment conditions and 1396 patients. Meta-analytic integration resulted in a significant but small effect size for short-term pain reduction (Hedges's g = 0.37, 95% confidence interval (CI): 0.27-0.48) and a small-to-medium effect size for long-term pain reduction over an average follow-up phase of 7.4 months (Hedges's g = 0.47, 95% CI: 0.3-0.65) for any psychological intervention. Psychological treatments also proved effective in reducing sleep problems (Hedges's g = 0.46, 95% CI: 0.28-0.64), depression (Hedges's g = 0.33, 95% CI: 0.20-0.45), functional status (Hedges's g = 0.42, 95% CI: 0.25-0.58), and catastrophizing (Hedges's g = 0.33, 95% CI: 0.17-0.49). These effects remained stable at follow-up. Moderator analyses revealed cognitive-behavioral treatment to be significantly better than other psychological treatments in short-term pain reduction (Hedges's g = 0.60, 95% CI: 0.46-0.76). Higher treatment dose was associated with better outcome. Publication-bias analyses demonstrated that the effect sizes were robust. The results suggest that the effects of psychological treatments for fibromyalgia are relatively small but robust and comparable to those reported for other pain and drug treatments used for this disorder. Cognitive-behavioral therapy was associated with the greatest effect sizes. (C) 2010 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved.