title: Fibromyalgia: can online cognitive behavioral therapy help?
abstract: BACKGROUND
  Cognitive behavioral therapy (CBT) has proven useful in treating fibromyalgia, depression, and anxiety. Computerized delivery of CBT allows increased access to such therapy. This study assessed the effect of internet-based CBT on Fibromyalgia Impact Questionnaire (FIQ) composite scores and tender point assessments.
  
  
  METHODS
  This 12-week randomized controlled trial included patients ≥18 years of age with 1990 American College of Rheumatology criteria for fibromyalgia and mild to moderate depression and anxiety. A total of 56 subjects were randomized into either a 6-week internet-based CBT group (MoodGYM) or a control group (standard care). We evaluated patients in both groups at 1-, 6-, and 12-week follow-up. The primary outcome measure was change in FIQ composite score. A secondary outcome measure was change in tender point assessment.
  
  
  RESULTS
  The mean age of study participants was 55 years, and 88% were female. Mean FIQ scores were significantly lower in the MoodGYM group compared to the control group (P<0.05 for group differences at 6 and 12 weeks). Mean tender point scores were also significantly lower in the MoodGYM group (P<0.001 at 6 and 12 weeks). We found no significant difference in the FIQ scores across the 3 timepoints in the MoodGYM group, but tender points showed a significant negative trend from baseline to 12-week follow-up.
  
  
  CONCLUSIONS
  Patients in the internet-based MoodGYM CBT program had lower FIQ and tender point scores at 6- and 12-week follow-up. Internet-based CBT could be beneficial in the treatment of mild to moderate depression and anxiety in patients with fibromyalgia by allowing increased access to CBT.
authors.affiliation: Department of Rheumatology, Ochsner Health Center-Baton Rouge, Baton Rouge, LA.
authors.forename: Gwendoline
authors.initials: G
authors.lastname: Menga
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Ing
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Omar
authors.initials: O
authors.lastname: Khan
authors.affiliation: Primary Care of Brusly, Port Allen, LA.
authors.forename: Bobby
authors.initials: B
authors.lastname: Dupre
authors.affiliation: Office of Biostatistical Support, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Dornelles
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Anika
authors.initials: A
authors.lastname: Alarakhia
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: William
authors.initials: W
authors.lastname: Davis
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Jerald
authors.initials: J
authors.lastname: Zakem
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Tamika
authors.initials: T
authors.lastname: Webb-Detiege
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Eve
authors.initials: E
authors.lastname: Scopelitis
authors.affiliation: Department of Rheumatology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Robert
authors.initials: R
authors.lastname: Quinet
keywords: Cognitive therapy; fibromyalgia; therapy–computer-assisted