ABSTRACT
OBJECTIVE: Multidisciplinary treatments of fibromyalgia (FM) have demonstrated efficacy. Nevertheless, they have been criticized for not maintaining their benefits and for not being studied for specific populations. Our objectives were to determine the efficacy of a multidisciplinary treatment for FM adapted for patients with low educational levels and to determine the maintenance of its therapeutic benefits during a long-term followup period. METHODS: Inclusion criteria consisted of female sex, a diagnosis of FM (using American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Patients were randomly assigned to 1 of the 2 treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were functionality, sleep disturbances, pain intensity, catastrophizing, and psychological distress. Analysis was by intent-to-treat and missing data were replaced following the baseline observation carried forward method. RESULTS: One hundred fifty-five participants were recruited. No statistically significant differences regarding pretreatment measures were found between the 2 experimental groups. Overall statistics comparison showed a significant difference between the 2 groups in all of the variables studied (P < 0.0001). Mixed linear model analysis demonstrated the superiority of the multidisciplinary treatment in all of the studied variables at posttreatment. The differences were maintained at 12-month followup in sleep disturbances (P < 0.0001), catastrophizing (P < 0.0001), and psychological distress (P < 0.01). CONCLUSION: Multidisciplinary treatment adapted for individuals with low educational levels is effective in reducing key symptoms of FM. Some improvements were maintained 1 year after completing the multidisciplinary treatment.
Subject(s)
Cognitive Behavioral Therapy/methods , Fibromyalgia/psychology , Fibromyalgia/therapy , Patient Education as Topic/methods , Physical Therapy Modalities , Adult , Analgesics/therapeutic use , Antidepressive Agents/therapeutic use , Combined Modality Therapy/methods , Educational Status , Female , Fibromyalgia/epidemiology , Humans , Middle Aged , Pain Measurement/methods , Treatment OutcomeABSTRACT
The authors review the most important Spanish contributions to hypnosis during the 19th and 20th centuries, with emphasis on the work of Santiago Ramon y Cajal, winner of the 1906 Nobel Prize in medicine. It is widely accepted that he provided a basic foundation for modern neurosciences with his work on neuronal staining and synaptic transmission. What is missing in most accounts of his work is his longstanding interest and work on hypnosis and anomalous phenomena. This article summarizes that lost legacy, discusses other Spanish hypnosis pioneers and gives a brief overview of current hypnosis activities in Spain.
