Operant behavioral treatment of fibromyalgia: a controlled study.
OBJECTIVE
To evaluate the efficacy of operant pain treatment for fibromyalgia syndrome (FMS) in an inpatient setting.


METHODS
Sixty-one patients who fulfilled the American College of Rheumatology criteria for FMS were randomly assigned to the operant pain treatment group (OTG; n = 40) or a standardized medical program with an emphasis on physical therapy (PTG; n = 21). Pain assessments were performed before, immediately after, 6 months after, and 15 months after treatment.


RESULTS
The OTG patients reported a significant and stable reduction in pain intensity, interference, solicitous behavior of the spouse, medication, pain behaviors, number of doctor visits, and days at a hospital as well as an increase in sleeping time. Sixty-five percent of the OTG compared with none of the patients in the PTG showed clinically significant improvement.


CONCLUSIONS
These results suggest that operant pain treatment provided in an inpatient setting is an effective treatment for FMS, whereas a purely somatically oriented program may lead to a deterioration of the pain problem.
Thieme
Kati
K
Department of Psychosomatic and Psychotherapeutic Medicine, University of Heidelberg, Central Institute of Mental Health, Mannheim, Germany. thieme@zi-mannheim.de
Gromnica-Ihle
Erika
E
Flor
Herta
H
D001519:Behavior; D016000:Cluster Analysis; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D004644:Emotions; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007297:Inpatients; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D010166:Palliative Care; D026741:Physical Therapy Modalities; D018454:Spouses / Q000523:psychology; D016896:Treatment Outcome