Differential responses by psychosocial subgroups of fibromyalgia syndrome patients to an interdisciplinary treatment.
OBJECTIVE
To evaluate differential treatment responses among 3 empirically derived, psychosocial subgroups of patients with fibromyalgia syndrome to a standard interdisciplinary treatment program.


METHODS
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.
Turk
D C
DC
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195-6540, USA.
Okifuji
A
A
Sinclair
J D
JD
Starz
T W
TW
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000339:Affect; D005260:Female; D005356:Fibromyalgia / Q000145:classification / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010147:Pain Measurement; D010347:Patient Care Planning; D010348:Patient Care Team / Q000458:organization & administration*; D016896:Treatment Outcome