AB0133 FIBROMIND: THE USE OF MINDFULNESS-BASED STRESS REDUCTION INTERVENTION AS A POTENTIAL “ADD-ON THERAPY” TO THE USUAL TREATMENTS FOR THE MANAGEMENT OF FIBROMYALGIA AND ITS IMPACT ON HOPE LEVELS

Background:

Hope is a goal-orientated cognitive construct comprising two components: pathways (achieving goals strategy) and agency (inspiring thoughts motivating to pursue goals). In rheumatic diseases, Hope is related to compliance and correlates with depression and symptoms worsening. Patients who experience chronic pain often tend to develop anxiety, depression, and a lack of hope regarding the improvement of their clinical condition. All of these can further increase the severity of the disease and resistance to various treatments.

Objectives:

The present study aims to assess Hope levels in patients with Fibromyalgia (FM) compared to healthy subjects (HS) and investigate whether a Mindfulness-based stress reduction (MBSR) intervention could increase Hope levels in FM patients and improve their physical and psychological status.

Methods:

64 FM female patients were consecutively enrolled in Campus Bio-Medico of Rome outpatient clinics and randomly assigned to either an MBSR intervention (n=31, consisting of 6 online sessions once a week) or not (n = 32). Moreover, 47 age- and sex-matched HS were recruited. All the groups completed the Adult Hope Scale (AHS) questionnaire at baseline. Only FM patients completed psychometric questionnaires at baseline and after three months: AHS, HADS to detect anxiety and depression symptoms, VAS-pain to assess pain, SCS to assess self-compassion, RS-14 to assess resilience, PCS to assess pain catastrophizing, SF-36 to assess health-related quality of life, PSS to assess stress, TAS-20 to assess alexithymia. FM disease severity has been evaluated by WPI, SSS, FSS, and FIQ-R. Continuous variables have been analyzed using the Mann-Whitney test for independent observations and the Wilcoxon test for paired data, while contingency tables have been analyzed using the Chi2 test. The statistical analysis has been performed using Stata v.14.

Results:

Comparative analysis at baseline showed that patients with FM have lower levels of hope as compared with HS [AHS 26 (24-27) and 22 (19-24), respectively, p<0.0001]. Both AHS Agency [13 (12-14) in FM group and 10 (9-12) in HS, p<0.0001] and AHS Pathways [13 (12-14) in FM group and 12 (10-13) in HS, p <0.0001] are reduced in FM patients compared to HS (Table 1). FM patients assigned to the MBSR group showed a significant improvement comparing baseline and after MBSR in WPI (p= 0.0300), SSS (p= 0.0141), FSS (p= 0.0104), FIQ-R (p <0.0001), HADS (p= 0.0005), PCS (p=0.0004), VAS-pain (p=0.0006) and PSS (p=0.0431). However, comparing baseline and after MBSR FM patients did not show improvement in SCS (p= 0.0888) [although statistically significant results were achieved in the SCS self-judgement (p= 0.0345) and SCS Isolation (p= 0.0078) subdomains], TAS-20 (p= 0.4535), RS-14 (p=0.0885) and SF-36 (p= 0.0545) [although significant variations were observed in the SF-36 Physical Functioning (p=0.0493), SF-36 Role-physical (p= 0.0028), SF-36 Social Functioning (p= 0.0003), and SF-36 Bodily Pain (p= 0.0001)] (Table 2). FM patients not undergoing MBSR intervention did not improve comparing baseline and after MBSR in any questionnaire.

Conclusion:

Hope levels in FM patients are significantly reduced compared to the healthy population. In FM, MBSR intervention induces improvement in the levels of Hope and, more specifically, its Agency component. This increase is associated with simultaneous improvement in physical function and various psychometric variables. Indeed, there is a reduction in anxiety, depression, perceived stress, and VAS-pain, as well as an improvement in FIQ-R and FSS, scores commonly used in clinical practice to assess the severity and impact of the disease on daily life. Therefore, MBSR is a promising treatment method for Fibromyalgia Syndrome. This chronic and debilitating condition still requires studies to investigate various aspects of the disease, including the identification of specific and effective therapies to improve patients' quality of life.

REFERENCES:

NIL.

Acknowledgements:

NIL.

Disclosure of Interests:

None declared.