[Fibromyalgia: influence of depressive symptoms on the outcome after rehabilitation].
BACKGROUND
For the therapy of fibromyalgia a multimodal therapy with patient education is recommended. It integrates pain management and stress management as well as cognitive restructuring. It will be examined whether depressiveness has an influence on rehabilitation outcome immediately after inpatient rehabilitation.


METHODS
Various questionnaires, i. e. the Hospital Anxiety and Depression Scale (HADS-D), German Pain Questionnaire (DSF), Cognitive, Behavioural Coping and Psychological Strains Through Chronic Pain questionnaire (FESV), German version of the Pain Anxiety Symptom Scale (PASS-D) and the Patient questionnaire IRES-24, were distributed to 102 fibromyalgia patients in the framework of a pre post design. The scores of patients with and without depressiveness (HADS-D cut-off >or=11) were compared by analysis of variance at two treatment points.


CONCLUSIONS
Immediately after therapy, a general improvement was found regarding depressiveness and pain (strong effect size) as well as regarding pain-related anxiety (medium effect sizes). Only "countertraded activity" of coping with pain did not show any improvement. The "rehabilitation status" improved significantly whereas, in contrast, the "physical health" aspect did not improve. A significant increase was found on the "pain" scale. Additionally, depressive symptoms had a strong impact on the aspects "physical health", "subjective health" and on "rehabilitation status". In particular, patients with fibromyalgia and depressiveness showed poorer outcomes regarding these aspects than patients with fibromyalgia without depressiveness. A multimodal therapy with patient education can have a positive impact on the outcome of rehabilitation.
Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, 28359 Bremen. meilange@uni-bremen.de
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Lange
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Krohn-Grimberghe
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Petermann
D000328:Adult; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation*; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome