A controlled study of a stress-reduction, cognitive-behavioral treatment program in fibromyalgia.

Objective: To determine the results of a stress-reduction, cognitive behavioral treatment [SR-CBT] program in fibromyalgia. Methods: Seventy-nine patients with fibromyalgia completed a 10 week meditation based SR-CBT program that met once weekly for 2 hours per session. Controls consisted of 42 fibromyalgia patients, 18 of whom had been placed on a waiting list for the treatment program and 24 randomly selected patients who had not expressed an interest in enrolling in the program. Medications and other treatments were not altered during the 10 week study. Fibromyalgia symptoms were evaluated at the beginning and at the end of the study in patients and controls by self-administered visual analog scales [VAS] for global well-being, pain, sleep, fatigue, and tiredness upon awakening. Functional status was evaluated by the Fibromyalgia Impact Questionnaire [FIQ], and psychological status by the SCL-90-R. Participants and controls were comparable at study entry. Results: Fibromyalgia symptoms improved in 67% of the participants in the SR-CBT program compared to 40% of the controls [P =. 006]. The mean VAS, adjusted for baseline, was decreased 16% in the participants compared to controls [P = 0.01]. The mean FIQ score in the participants decreased 11% compared to the control group baseline [P = 0.05]. Most impressively, the global severity index of the SCL-90-R improved by 32% [P = 0.0001]. Conclusion: A SR-CBT program is a useful adjunct in the treatment of patients with fibromyalgia.