Different CBT treatments are equally effective against fibromyalgia –

In Sweden, about 200,000 people live with fibromyalgia today. It is a long-term pain condition with widespread pain, fatigue and stiffness throughout the body.

There is currently no curative treatment for fibromyalgia and existing medications often do not have a good enough effect.

Treatment with cognitive behavioral therapy, CBT, has been shown to have some effect. But it was not clear which form of cognitive behavioral therapy gave the best results.

Two different forms of cognitive behavioral therapy

A new study has now compared two different forms of Internet-based cognitive behavioral therapy to see how they help reduce fibromyalgia symptoms.

One such form is called exposure-based cognitive behavioral therapy. This means that the participant systematically and repeatedly approaches situations or activities that were previously avoided because they were associated with pain, psychological discomfort, or symptoms such as fatigue and cognitive problems.

The other is traditional cognitive behavioral therapy where the participant is able to work with different strategies during treatment. This can include relaxation, planning activities, physical exercise, dealing with negative thoughts, and improving sleep.

Equivalent results

In the study, approximately 270 people with fibromyalgia were randomly assigned to different treatments, which were delivered online. Everyone had regular contact with their therapist.

The study showed that traditional cognitive behavioral therapy was broadly equivalent to the newer form of treatment, exposure-based cognitive behavioral therapy. This surprised the researchers.

The result was surprising because our hypothesis, based on previous research, was that the new exposure-based format would be more effective. Our study shows that the traditional format can give an equally good result, and thus contributes to the discussion in this field, says Maria Hedmann Lagerlöf, psychologist and researcher at the Karolinska Institutet.

Both treatments reduce symptoms

Participants had to answer questions about their health and problems before, during and after treatment. After ten weeks of treatment, 60% of patients who received exposure-based cognitive behavioral therapy reported that their treatment had helped them. Among patients who received traditional cognitive behavioral therapy, 59% reported that the treatment helped them.

Both treatments were associated with a significant reduction in participants' symptoms and functional impact, and that the effects persisted for twelve months after the end of treatment, suggesting that the Internet as a therapeutic form could be of great clinical benefit to people. With fibromyalgia, Maria Hedmann-Lagerlöf says and continues:

– This is good news because it enables more people to get treatment.

The study is a collaboration between Karolinska Institutet and Uppsala University.

Scientific study:

Effect of exposure-based cognitive behavioral therapy versus conventional cognitive behavioral therapy for fibromyalgia: a single-blind, randomized controlled trial at two sites., pain.

communication:

Maria Hedmann Lagerlöf is a licensed psychologist and researcher
Center for Psychiatric Research at the Department of Clinical Neuroscience, Karolinska Institutet, [email protected]