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Differential responses by psychosocial subgroups of fibromyalgia (FM) syndrome patients to an interdisciplinary treatment

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By Turk DC, Okifuji A, Sinclair JD, Starz TW • www.ProHealth.com • October 5, 1998


OBJECTIVES: To evaluate differential treatment responses among
3 empirically derived, psychosocial subgroups of patients with
fibromyalgia syndrome to a standard interdisciplinary
treatment program.

METHOD: Patients were classified into 1 of
3 psychosocial groups on the basis of their responses to the
Multidimensional Pain Inventory. Forty-eight patients
completed a 6 one-half-day outpatient treatment program
consisting of medical, physical, occupational, and
psychological therapies spaced over a period of 4 weeks (3
sessions the first week followed by 1 session per week for the
next 3 consecutive weeks).

RESULTS: Statistically significant
reductions were observed in pain, affective distress,
perceived disability, and perceived inteference of pain in the
patients characterized by poor coping and high level of pain
("dysfunctional" group). In contrast, individuals who were
characterized by interpersonal difficulties ("interpersonally
distressed" group) exhibited poor responses to the treatment.
"Adaptive copers," the third group, revealed significant
improvements in pain but due to low pretreatment levels of
affective distress and disability showed little improvement on
these outcomes.

CONCLUSIONS: The results provided support for
the hypothesis that customizing treatment based on patients'
psychosocial needs will lead to enhanced treatment efficacy.
They also emphasize the importance of using appropriate
outcome criteria, as low levels of problems at baseline are
not likely to show significant changes following any
treatment.




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