Stress management as a clinical approach to the complementary treatment of fibromyalgia

Abstract

Fibromyalgia is a chronic syndrome that can have a devastating effect on the lives of those who suffer from it. These types of patients experience high levels of pain, as well as deficits in terms of positive affect and social relationships, which are not explicitly addressed in pharmacological treatments. Objectives: To know how pharmacological interventions combined with various stress management techniques reduce pain perception in adult patients clinically diagnosed with fibromyal-gia. Data sources, study eligibility criteria: The search for the articles was carried out from January 2010 to July 2021, in six databases (Web Of Science (WOS), Scopus, Cochrane, Psycinfo, Psicodoc, Psychology and Behavioral Sciences Collection and Pubpsych) based on the clinical question, using the keywords derived from the DeCS and MeSH thesauri, combined with the Boolean operators “AND”, “NOT” and “OR”. The search was limited to publications from the last 11 years, in English or Spanish, based on randomized controlled studies (RCTs), and covering patients with a clinical and medical diagnosis of fibromyalgia, between 18 and 65 years of age, and of both genders. Results: Thirteen RCTs were included with a total sample of 2218 participants, where the mean methodologi-cal quality obtained from the studies reviewed using the PEDro scale was 7.07. The combined data showed a marked improvement in the quality of life of the patient (p < 0.001). Regarding other units measured during the review, a significant reduction could be observed in perceived pain (p < 0.001), stress (p < 0.001), anxiety (p < 0.001) and depression (p < 0.001). Conclusions and implications of key findings: Multidisciplinary treatment leads to notable improvements compared to conservative or pharmacological treatment, improving quality of life, social support, mental self-control and satisfac-tion. Cognitive-behavioral therapy favored therapeutic adherence, achieving in turn a decrease in anxiety, depression and vital exhaustion.