This article considers four broad classes of psychological techniques and their effects on fibromyalgia (FM) pain. A literature search identified 14 randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT), five relaxation RCTs, five biofeedback RCTs, five hypnotherapy RCTs, and two writing intervention RCTs. For psychoanalytic therapy in FM, no RCTs have been published. The highest effect sizes (r = 0.53-2.14) for pain reduction are found after CBT and OBT group treatments. Relaxation as a single treatment has not been proven useful. Hypnotherapy and writing intervention have demonstrated mild treatment effects, whereas psychological treatment is effective in FM pain. Considering the heterogeneity of FM, the promising effects of matched interventions such as CBT and OBT with pharmacotherapy, exercise, and other treatment domains require further research.
Curr Rheumatol Rep. 2009 Dec;11(6):443-50. Thieme K, Gracely RH. Center for Neurosensory Disorders, University of North Carolina, CB#7280, 3330 Thurston Building, Chapel Hill, NC 27599, USA. email@example.com