RESUMO
There is growing evidence to support the potential benefit of e-Health interventions targeting psychosocial outcomes and/or pain-related psychological variables for chronic pain conditions, including fibromyalgia syndrome (FMS). This systematic review aims at providing an in-depth description of the available e-Health psychological and/or multicomponent interventions for patients with FMS. Searches were made in PubMed, Cochrane, Web of Science, and PsycINFO up to 15 May 2023, finally including twenty-six articles. The quality of the included articles was medium-high (average quality assessment score of 77.1%). 50% of studies were randomized controlled trials (RCTs) (n = 13), and the majority of them focused exclusively on adult patients with FMS (n = 23) who were predominantly female. Four categories of e-Health modalities were identified: web-based (n = 19), mobile application (m-Health) (n = 3), virtual reality (VR) (n = 2), and video consulting (n = 2). Interventions were mainly based on the cognitive behavioral therapy (CBT) approach (n = 14) and mostly involved contact with a healthcare professional through different digital tools. Overall, a growing number of psychological and multicomponent interventions have been created and delivered using digital tools in the context of FMS, showing their potentiality for improving psychosocial outcomes and pain-related psychological variables. However, some digital tools resulted as underrepresented, and the literature on this topic appears highly heterogeneous precluding robust conclusions.
RESUMO
Fibromyalgia (FM) is a chronic disease characterized by a heterogeneous set of physical and psychological conditions. The chronic experience of disability felt by patients and the impact on quality of life (QoL) of the disease may worsen the cognitive reappraisal ability and contribute to maintaining an altered pain modulation mechanism. This paper presents the study protocol of an INTEGRated psychotherapeutic interventiOn on the management of chronic pain in patients with fibromyalgia (INTEGRO). The aim of the study is to investigate the efficacy of an integrated psychotherapeutic intervention focused on pain management on QoL and pain perception, in a pilot sample of 45 FM patients with idiopathic chronic pain. The contribution of perceived therapeutic relationship (alliance) and physiological attunement, in both the patient and therapist, will be considered as possible mediators of intervention efficacy. Attachment dimensions, traumatic experiences, difficulties in emotion regulation, mindfulness attitude and psychophysiological profile will also be considered as covariates. The objectives are to evaluate longitudinally if patients will experience an increase in QoL perception (primary endpoint), pain-managing self-efficacy and emotion-regulation abilities as well as a reduction in pain intensity (secondary endpoints), considering the mediating role of perceived therapeutic alliance and physiological attunement in both the patient and therapist.
Assuntos
Dor Crônica , Fibromialgia , Humanos , Fibromialgia/terapia , Dor Crônica/complicações , Qualidade de Vida/psicologia , Manejo da Dor/métodos , CogniçãoRESUMO
Major depression (MDD) has been associated with an altered EEG frontal asymmetry measured in resting state; nevertheless, this association has showed a weak consistency across studies. In the present study, which starts from an evolutionistic view of psychiatric disorders, we investigated frontal asymmetry in MDD, using language as a probe to test the integrity of large inter- and intra-hemispheric networks and processes. Thirty MDD patients (22 women) and 32 matched controls (HC) were recruited for an EEG recording in resting state and during two linguistic tasks, phonological and semantic. Normalized alpha and beta EEG spectral bands were measured across all three conditions in the two groups. EEG alpha amplitude showed no hemispheric asymmetry, regardless of group, both at rest and during linguistic tasks. During resting state, analysis of EEG beta revealed a lack of hemispheric asymmetry in both groups, but during linguistic tasks, HC exhibited the typical greater left frontal beta activation, whereas MDD patients showed a lack of frontal asymmetry and a significantly lower activation of left frontal sites. In depressed patients, positive affect was negatively correlated with depression levels and positively correlated with left frontal EEG beta amplitude. Language represents the human process that requires the largest level of integration between and within the hemispheres; thus, language asymmetry was a valid probe to test the left frontal alteration encompassing highly impairing psychiatric disorders, such as schizophrenia and MDD. Indeed, these severe diseases are marked by delusions, ruminations, thought disorders, and hallucinations, all of which have a clear linguistic or metalinguistic basis.
