title: A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome.
abstract: OBJECTIVE
  This paper presents a systematic review and meta-analysis of the effectiveness of mindfulness-based stress reduction (MBSR) for FMS.
  
  
  METHODS
  The PubMed/MEDLINE, Cochrane Library, EMBASE, PsychINFO and CAMBASE databases were screened in September 2013 to identify randomized and non-randomized controlled trials comparing MBSR to control interventions. Major outcome measures were quality of life and pain; secondary outcomes included sleep quality, fatigue, depression and safety. Standardized mean differences and 95% confidence intervals were calculated.
  
  
  RESULTS
  Six trials were located with a total of 674 FMS patients. Analyses revealed low quality evidence for short-term improvement of quality of life (SMD=-0.35; 95% CI -0.57 to -0.12; P=0.002) and pain (SMD=-0.23; 95% CI -0.46 to -0.01; P=0.04) after MBSR, when compared to usual care; and for short-term improvement of quality of life (SMD=-0.32; 95% CI -0.59 to -0.04; P=0.02) and pain (SMD=-0.44; 95% CI -0.73 to -0.16; P=0.002) after MBSR, when compared to active control interventions. Effects were not robust against bias. No evidence was further found for secondary outcomes or long-term effects of MBSR. Safety data were not reported in any trial.
  
  
  CONCLUSIONS
  This systematic review found that MBSR might be a useful approach for FMS patients. According to the quality of evidence only a weak recommendation for MBSR can be made at this point. Further high quality RCTs are required for a conclusive judgment of its effects.
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany. Electronic address: r.lauche@kliniken-essen-mitte.de.
authors.forename: Romy
authors.initials: R
authors.lastname: Lauche
authors.forename: Holger
authors.initials: H
authors.lastname: Cramer
authors.forename: Gustav
authors.initials: G
authors.lastname: Dobos
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
authors.forename: Stefan
authors.initials: S
authors.lastname: Schmidt
mesh_terms: D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control; D005356:Fibromyalgia / Q000523:psychology*; D006801:Humans; D064866:Mindfulness; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D013315:Stress, Psychological / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*
keywords: Chronic widespread pain; Fibromyalgia syndrome; MBSR; Meta-analysis; Mindfulness; Systematic review