Fibromyalgia Clinical Trial
Official title:
Psychological Treatment of Depression in Women With Fibromyalgia: Differential Efficacy and Factors Predictive of Outcome
The purpose of this study is to perform an efficacy study of Personal Construct Therapy, which focuses on the construction of self and others, for women diagnosed with fibromyalgia who have also comorbid depressive symptoms. To that aim, it will be compared with Cognitive Behavioral Therapy, which is an already well-established treatment in this area.
Fibromyalgia is one of the most demanding health issues nowadays due to the high level of
suffering and the deterioration of quality of life it entails. In addition, its high
prevalence and the great expenses it implies for social and health care systems are also
matter of both public and politic concern.
Previous research has shown that the personal affliction triggered by fibromyalgia is
influenced by psychological factors, which have also an effect on the socioeconomic burden of
this disease as a consequence. Among these factors, depressive symptoms are highlighted in
this study not only because they exacerbate the clinical profile of this type of patients,
but also because they decrease their response to treatment, contributing to the chronicity of
this disease. In fact, the treatment of depressive symptoms is already one of the therapeutic
targets included in the most recommended multicomponent (and multidisciplinary) treatment
guidelines for fibromyalgia.
In spite of the growing number of studies supporting the efficacy of psychological therapies
for fibromyalgia, many issues need further development. For example, current treatment
recommendations for this syndrome suggest that the intervention must be tailored to the
psychosocial and functioning profile of patients. However, research is still needed in order
to enable the identification of key factors for clinical improvement. Similarly, it is
crucial to identify and assess idiosyncratic psychological characteristics that may allow the
psychological intervention to be effectively adapted. In addition, an evidence-based
description of the mechanisms involved in change at different levels (including psychological
and physical ones) has not been developed yet.
The aim of this project is to perform an efficacy study of Personal Construct Therapy (PCT),
which focuses on the construction of self and others, for women diagnosed with fibromyalgia
who have also comorbid depressive symptoms. It will be compared with Cognitive Behavioral
Therapy (CBT), which is a well-established treatment in this area. Both interventions will be
performed in individual format. Depressive symptoms will be measured before and after
treatments, along with other clinical and wellbeing-related variables. The cognitive indexes
derived from the Repertory Grid Technique, such as cognitive conflicts, polarization and
self-construction measures, will also be assessed. Moreover, the capacity of all these
measures for predicting differential outcomes resulting from both treatments will also be
estimated. The relevance of these cognitive indicators for depression and fibromyalgia has
already been proven by this research group in previous studies.
It is expected that PCT will be more effective than standard CBT in improving clinical
symptoms and wellbeing. Additionally, the identification of patients' cognitive
characteristics which may have a differential response to the components of each treatment
will allow future adaptation of psychological interventions to the characteristics of
patients, which will contribute in turn to the improvement of the existing treatments.
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