ABSTRACT
OBJECTIVE: The purpose of the present study was to evaluate the effectiveness of a brief cognitive-behavioral therapy (CBT) group intervention for fibromyalgia syndrome in routine care. METHOD: Thirty-four female outpatients who participated in a 5- to 6-week group CBT program were assessed for depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), coping strategies (Coping Questionnaire for Chronic Pain), physical functioning (Fibromyalgia Impact Questionnaire), and somatization (Health Attitude Survey) at 3 time points (baseline, pretreatment, and posttreatment) using a pre-post, quasi-experimental design. RESULTS: Twenty-three female outpatients (68% of the initial sample) for which data were available in all 3 time points were included in the analyses. No changes were found during the waiting period. During the treatment period, there were significant reductions in depression (P = .001) and anxiety (P = .006) symptoms and an increased use of distraction skills (P < .001). The analysis of rate of change showed a significant correlation between anxiety and depression (P = .004), but not between these variables and the use of distraction as a coping strategy. CONCLUSION: Brief group CBT is effective in reducing emotional distress in female patients with long-standing fibromyalgia syndrome in the context of routine care. Attention-distraction skills appear to be amenable to change by means of brief CBT, but further research is needed to clarify their contribution to short-term clinical improvement.
Subject(s)
Cognitive Behavioral Therapy , Fibromyalgia/psychology , Adaptation, Psychological , Anxiety/therapy , Depression/therapy , Female , Fibromyalgia/therapy , Humans , Middle Aged , Pain Management , Patient Satisfaction , Psychotherapy, Group , Stress, Psychological/therapy , Treatment OutcomeABSTRACT
El alcohol es la droga que más implicaciones sociales y sanitarias crea en España. Se estima que hasta el 75% de los alcohólicos presentan alteraciones neuropsicológicas como consecuencia del consumo de alcohol, en áreas como las capacidades visoperceptivas, visoconstructivas, mnésicas, ejecutivas, de abstracción y solución de problemas. Estudios recientes han destacado la relación existente entre los déficit cognitivos y el pronóstico y eficacia de los programas de tratamiento en esta población. Se presenta un estudio preliminar cuyo objetivo es conocer la afectación de distintas funciones cognitivas en las fases iniciales de la abstinencia (12-16 días) al inicio de un programa de intervención. Se realizó una evaluación neuropsicológica de una muestra de 15 participantes alcohólicos crónicos en abstinencia y 15 controles. Se aplicaron pruebas para obtener una evaluación cognitiva extensa que abarcase distintas competencias. Atención, memoria, habilidades visoperceptivas, visocontructivas y funciones ejecutivas (flexibilidad mental e inhibición de respeuestas automáticas, fluidez verbal de categorías fonéticas, asignación de recursos atencionales para el procesamiento de la información). Los sujetos alcohólicos mostraron, en comparación con el grupo control, alteraciones en el control atencional, velocidad de procesamiento de la información, inhibición de respuestas automáticas, función visuoespacial y memoria visual
Alcohol is the drug with the most social and heatlh assocated consequences inSpain. It is estimated that up to 75% of alcoholic patients presents neuropsychological deficit related to their alcohol consumption. These difficulties appear to involve visuoperceptual and visuoconstructional skills, memory, executive functions, abstraction and problem solving. Recent studies have shown the relationship between cognitive deficit and the prognosis and efficacy of the rehabilitation programmes in this population. This preliminary study evaluates the cognitive dysfunctions inthe earliest phases of the abstinence period (12-16 days) at the begining of a rehabilitation programme. A neuropsychological assessment was given to 15 chronic alcoholic patients in abstinence and 15 control subjects. Different tests were applied to these subjects in order to obtain a comprehensive cognitive profile. Several functions were assessed: attention, memory, visoperceptual and visuoconstructional skills, and executive functions. The alcoholic participants showed a poorer performance in tests related to attention control, performance speed, automatic response inhibition, visuospatial function and visual memory in comparison with the control group
