MBSR Not Particularly Effective for Fibromyalgia

Cort

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This is really interesting study because Fibromyalgia is the type of disorder one would think would helped by mindfulness based stress reduction because it was developed to treat pain disorders. MBSR did help quality of life but it had limited effects on FM measures. An earlier less rigorous study had found better effects.

Its a little help but it's not really a treatment.

Not surprisingly it was a European study and it was a big one - 177 patients...It looks like this was their big shot at mind/body interventions for FM...



Pain. 2010 Dec 10. [Epub ahead of print]
Treating fibromyalgia with mindfulness-based stress reduction: Results from a 3-armed randomized controlled trial.

Schmidt S, Grossman P, Schwarzer B, Jena S, Naumann J, Walach H.
Department of Environmental Health Sciences, University Medical Center, Freiburg, Germany; Institute for Transcultural Health Studies, European University Viadrina, Frankfurt (Oder), Germany; Samueli Institute, European Office, Brain, Mind and Healing Programme, Germany; Heymans Chair of Exceptional Human Experiences, University for the Humanistics, Utrecht, The Netherlands.
Abstract

Mindfulness-based stress reduction (MBSR) is a structured 8-week group program teaching mindfulness meditation and mindful yoga exercises. MBSR aims to help participants develop nonjudgmental awareness of moment-to-moment experience. Fibromyalgia is a clinical syndrome with chronic pain, fatigue, and insomnia as major symptoms.

Efficacy of MBSR for enhanced well-being of fibromyalgia patients was investigated in a 3-armed trial, which was a follow-up to an earlier quasi-randomized investigation. A total of 177 female patients were randomized to one of the following: (1) MBSR, (2) an active control procedure controlling for nonspecific effects of MBSR, or (3) a wait list.

The major outcome was health-related quality of life (HRQoL) 2months post-treatment. Secondary outcomes were disorder-specific quality of life, depression, pain, anxiety, somatic complaints, and a proposed index of mindfulness. Of the patients, 82% completed the study.

There were no significant differences between groups on primary outcome, but patients overall improved in HRQoL at short-term follow-up (P=0.004). Post hoc analyses showed that only MBSR manifested a significant pre-to-post-intervention improvement in HRQoL (P=0.02). Furthermore, multivariate analysis of secondary measures indicated modest benefits for MBSR patients. MBSR yielded significant pre-to-post-intervention improvements in 6 of 8 secondary outcome variables, the active control in 3, and the wait list in 2.

In conclusion, primary outcome analyses did not support the efficacy of MBSR in fibromyalgia, although patients in the MBSR arm appeared to benefit most. Effect sizes were small compared to the earlier, quasi-randomized investigation. Several methodological aspects are discussed, e.g., patient burden, treatment preference and motivation, that may provide explanations for differences. In a 3-armed randomized controlled trial in female patients suffering from fibromyalgia, patients benefited modestly from a mindfulness-based stress reduction intervention.


Copyright 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserv