Background: Mindfulness-based stress reduction (MBSR) proposes a systematic program for reduction of suffering associated with a wide range of medical conditions. Studies suggest improvements in general aspects of well-being, including quality of life (QoL), coping and positive affect, as well as decreased anxiety and depression. Methods: A quasi-experimental study examined effects of an 8-week MBSR intervention among 58 female patients with fibromyalgia (mean, 52 ± 8 years) who underwent MBSR or an active social support procedure. Participants were assigned to groups by date of entry, and 6 subjects dropped out during the study. Self-report measures were validated German inventories and included the following scales: visual analog pain, pain perception, coping with pain, a symptom checklist and QoL. Pre- and postintervention measurements were made. Additionally, a 3-year follow-up was carried out on a subgroup of 26 participants. Results: Pre- to postintervention analyses indicated MBSR to provide significantly greater benefits than the control intervention on most dimensions, including visual analog pain, QoL subscales, coping with pain, anxiety, depression and somatic complaints (Cohen d effect size, 0.40–1.10). Three-year follow-up analyses of MBSR participants indicated sustained benefits for these same measures (effect size, 0.50–0.65). Conclusions: Based upon a quasi-randomized trial and long-term observational follow-up, results indicate mindfulness intervention to be of potential long-term benefit for female fibromyalgia patients.

1.
Jacobsson L, Lindgarde F, Manthorpe R: The commonest rheumatic complaints of over six weeks’ duration in a twelve-month period in a defined Swedish population. Prevalences and relationships. Scand J Rheumatol 1989;18:353–360.
2.
Buskila D, Neumann L: Fibromyalgia syndrome and nonarticular tenderness in relatives of patients with fibromyalgia. J Rheumatol 1997;24:941–944.
3.
Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L: The prevalence and characteristics of ibromyalgia in the general population. Arthritis Rheum 1995;38:19–28.
4.
Raspe HH, Schochat T: Epidemiology of the fibromyalgia syndrome: definition, occurrence, consequences, risk factors. Z Rheumatol 1997 1997;56:359–360.
5.
White KP, Carette S, Harth M, Teasell RW: Trauma and fibromyalgia: is there an association and what does it mean? Semin Arthritis Rheum 2000;29:200–216.
6.
Netter P, Hennig J: The fibromyalgia syndrome as a manifestation of neuroticism? Z Rheumatol 1998;57(suppl 2):105–108.
7.
Keel P: Psychological and psychiatric aspects of fibromyalgia syndrome. Z Rheumatol 1998;57(suppl 2):97–100.
8.
Offenbaecher M, Glatzeder K, Ackenheil M: Self-reported depression, familial history of depression and fibromyalgia (FM), and psychological distress in patients with FM. Z Rheumatol 1998;57(suppl 2):94–96.
9.
Goldberg RT, Pachas WN, Keith D: Relationship between traumatic events in childhood and chronic pain. Disabil Rehabil 1999;21:23–30.
10.
Thieme K, Turk DC, Flor H: Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables. Psychosom Med 2004;66:837–844.
11.
Fischler B, Cluydts R, De Gucht Y, Kaufman L, De Meirleir K: Generalized anxiety disorder in chronic fatigue syndrome. Acta Psychiatr Scand 1997;95:405–413.
12.
Van Houdenhove B, Egle UT: Fibromyalgia: a stress disorder? Piecing the biopsychosocial puzzle together. Psychother Psychosom 2004;73:267–275.
13.
Clauw DJ, Crofford LJ: Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol 2003;17:685–701.
14.
Wessely S, Hotopf M: Is fibromyalgia a distinct clinical entity? Historical and epidemiological evidence. Baillieres Best Pract Res Clin Rheumatol 1999;13:427–436.
15.
Wolfe F: The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic. Ann Rheum Dis 1997;56:268–271.
16.
Schochat T, Raspe H: Elements of fibromyalgia in an open population. Rheumatology 2003;42:829–835.
17.
Penrod JR, Bernatsky S, Adam V, Baron M, Dayan N, Dobkin PL, Williams DA, Cary MA, Groner KH, Chaplin W, Glazer LJ, Rodriguez AM, Clauw DJ: Health services costs and their determinants in women with fibromyalgia: Improving physical functional status in patients with fibromyalgia: a brief cognitive behavioral intervention. J Rheumatol 2004;31:1391–1398.
18.
Robinson RL, Birnbaum HG, Morley MA, Sisitsky T, Greenberg PE, Claxton AJ: Economic cost and epidemiological characteristics of patients with fibromyalgia claims. J Rheumatol 2003;30:1318–1325.
19.
Rossy LA, Buckelew SP, Dorr N, Hagglund KJ, Thayer JF, McIntosh MJ, Hewett JE, Johnson JC: A meta-analysis of fibromyalgia treatment interventions. Ann Behav Med 1999;21:180–191.
20.
Holdcraft LC, Assefi N, Buchwald D: Complementary and alternative medicine in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol 2003;17:667–683.
21.
Williams DA: Psychological and behavioural therapies in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol 2003;17:649–665.
22.
Mannerkorpi K, Iversen MD: Physical exercise in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol 2003;17:629–647.
23.
Rao SG, Bennett RM: Pharmacological therapies in fibromyalgia. Best Pract Res Clin Rheumatol 2003;17:611–627.
24.
Kabat-Zinn J: Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York, Delacorte, 1990.
25.
Schleicher H, Alonso C, Shirtcliff EA, Muller D, Loevinger BL, Coe CL: In the face of pain: the relationship between psychological well-being and disability in women with fibromyalgia. Psychother Psychosom 2005;74:231–239.
26.
Grossman P, Niemann L, Schmidt S, Walach H: Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 2004;57:35–43.
27.
Heidenreich T, Tuin I, Pflug B, Michal M, Michalak J: Mindfulness-based cognitive therapy for persistent insomnia: a pilot study. Psychother Psychosom 2006;75:188–189.
28.
Weiss M, Nordlie JW, Siegel EP: Mindfulness-based stress reduction as an adjunct to outpatient psychotherapy. Psychother Psychosom 2005;74:108–112.
29.
Kaplan KH, Goldenberg DL, Galvin-Nadeau M: The impact of a meditation-based stress reduction program on fibromyalgia. Gen Hosp Psychiatry 1993;15:284–289.
30.
Goldenberg DL, Kaplan KH, Nadeau MG, Brodeur C, Smith S, Schmid CH: A controlled study of a stress-reduction, cognitive-behavioral treatment program in fibromyalgia. J Musculoskelet Pain 1994;2:53–66.
31.
Astin JA, Berman BM, Bausell B, Lee WL, Hochberg M, Forys KL: The efficacy of mindfulness meditation plus qigong movement therapy in the treatment of fibromyalgia: a randomized controlled trial. J Rheumatol 2003;30:2257–2262.
32.
Snaith RP: The hospital anxiety and depression scale. Health Qual Life Outcomes 2003;1:29.
33.
Scott J, Huskisson EC: Graphic representation of pain. Pain 1976;2:175–184.
34.
Siegrist J, Broer M, Junge A: Profil der Lebensqualität chronisch Kranker. Handanweisung. Göttingen, Beltz Test, 1996.
35.
Herrmann C, Buss U, Snaith RP: HADS-D. Hospital Anxiety and Depression Scale-deutsche Version. Ein Fragebogen zur Erfassung von Angst und Depressivität in der somatischen Medizin. Testdokumentation und Handanweisung. Bern, Huber, 1995.
36.
Geissner E: Die Schmerzempfindungsskala (SES). Handanweisung. Göttingen, Hogrefe, 1996.
37.
Schermelleh-Engel K: Fragebogen zur Schmerzregulation (FSR). Handanweisung. Frankfurt, Swets, 1995.
38.
Rugulies R, Krasemann EO, Siegrist J: Evaluation ärztlich betreuter Reisen für Herzkranke (‘Herzreisen’). Zufriedenheit der Reiseteilnehmer und langfristige Auswirkungen auf die gesundheitsbezogene Lebensqualität. Rehabilitation 2003;42:211–217.
39.
Siegrist J, Rugulies R: Lebensqualität bei fortgeschrittener koronarer Herzkrankheit. Z Kardiol 1997;1:1–7.
40.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–370.
41.
Egle UT: Strukturierte biographische Anamnese für Schmerzpatienten (Version IV); in Egle UT, Hoffmann SO (eds): Der Schmerzkranke. Grundlagen, Pathogenese, Klinik und Therapie chronischer Schmerzsyndrome aus bio-psycho-sozialer Sicht. Stuttgart, Schattauer, 1993, pp 617–659.
42.
Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, Russell IJ, Yunus MB: Health status and disease severity in fibromyalgia: results of a six-center longitudinal study. Arthritis Rheum 1997;40:1571–1579.
43.
Baumgartner E, Finckh A, Cedraschi C, Vischer TL: A six year prospective study of a cohort of patients with fibromyalgia. Ann Rheum Dis 2002;61:644–645.
44.
Neumann L, Zeldets V, Bolotin A, Buskila D: Outcome of posttraumatic fibromyalgia: a 3-year follow-up of 78 cases of cervical spine injuries. Semin Arthritis Rheum 2003;32:320–325.
45.
Noller V, Sprott H: Prospective epidemiological observations on the course of the disease in fibromyalgia patients. J Negat Results Biomed 2003;2:4.
46.
Feiler S, Muller KG, Muller A, Dahlhaus R, Eich W: Using interaction graphs for analysing the therapy process. Psychother Psychosom 2005;74:93–99.
47.
Viane I, Crombez G, Eccleston C, Poppe C, Devulder J, Van Houdenhove B, De Corte W: Acceptance of pain is an independent predictor of mental well-being in patients with chronic pain: empirical evidence and reappraisal. Pain 2003;106:65–72.
48.
Schachter CL, Busch AJ, Peloso PM, Sheppard MS: Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther 2003;83:340–358.
49.
Offenbaecher M, Ackenheil M: Current trends in neuropathic pain treatments with special reference to fibromyalgia. CNS Spectr 2005;10:285–297.
50.
Turk DC, Robinson JP, Burwinkle T: Prevalence of fear of pain and activity in patients with fibromyalgia syndrome. J Pain 2004;5:483–490.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.