title: Follow-up of Yoga of Awareness for Fibromyalgia: Results at 3 Months and Replication in the Wait-list Group Self-report Mindfulness as a Mediator of Psychological Well-being in a Stress Reduction Intervention for Cancer Patients—A Randomized Study Mindfulness Training as an Intervention for Fibromyalgia: Evidence of Postintervention and 3-Year Follow-Up Benefits in Well-Being Treating fibromyalgia with mindfulness-based stress reduction: Results from a 3-armed randomized controlled trial A cohort-controlled trial of the addition of customized foot orthotics to standard care in fibromyalgia The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms. The efficacy of mindfulness meditation plus Qigong movement therapy in the treatment of fibromyalgia: a randomized controlled trial. Clinical and Economic Characteristics of Patients With Fibromyalgia Syndrome Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial. Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up.
abstract: Objectives : Published preliminary findings from a r and omized-controlled trial suggest that an 8-week Yoga of Awareness intervention may be effective for improving symptoms , functional deficits , and coping abilities in fibromyalgia . The primary aims of this study were to evaluate the same intervention ’s posttreatment effects in a wait-list group and to test the intervention ’s effects at 3-month follow-up in the immediate treatment group . Methods : Unpaired t tests were used to compare data from a per protocol sample of 21 women in the immediate treatment group who had completed treatment and 18 women in the wait-list group who had completed treatment . Within-group paired t tests were performed to compare posttreatment data with 3-month follow-up data in the immediate treatment group . The primary outcome measure was the Fibromyalgia Impact Question naire Revised ( FIQR ) . Multilevel r and om-effects models were also used to examine associations between yoga practice rates and outcomes . Results : Posttreatment results in the wait-list group largely mirrored results seen at posttreatment in the immediate treatment group , with the FIQR Total Score improving by 31.9 % across the 2 groups . Follow-up results showed that patients sustained most of their posttreatment gains , with the FIQR Total Score remaining 21.9 % improved at 3 months . Yoga practice rates were good , and more practice was associated with more benefit for a variety of outcomes . Discussion : These findings indicate that the benefits of Yoga of Awareness in fibromyalgia are replicable and can be maintained Background There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning . Purpose The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes . Methods Seventy women and one man with a previous cancer diagnosis ( mean age 51.8 years , st and ard deviation = 9.86 ) were r and omized into an intervention group or a wait-list control group . The intervention consisted of an 8-week mindfulness training course . Results Compared to participants in the control group , participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind . Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness question naire ( FFMQ ) when compared to controls . The increase in FFMQ score mediated the effects of the intervention on perceived stress , posttraumatic avoidance symptoms , and positive states of mind . Conclusions This study indicates that the improvements in psychological well-being result ing from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ . The importance of these findings for future research in the field of mindfulness is discussed Background : Mindfulness-based stress reduction ( MBSR ) proposes a systematic program for reduction of suffering associated with a wide range of medical conditions . Studies suggest improvements in general aspects of well-being , including quality of life ( QoL ) , coping and positive affect , as well as decreased anxiety and depression . Methods : A quasi-experimental study examined effects of an 8-week MBSR intervention among 58 female patients with fibromyalgia ( mean , 52 ± 8 years ) who underwent MBSR or an active social support procedure .  Participants were assigned to groups by date of entry , and 6 subjects dropped out during the study . Self-report measures were vali date d German inventories and included the following scales : visual analog pain , pain perception , coping with pain , a symptom checklist and QoL. Pre- and postintervention measurements were made . Additionally , a 3-year follow-up was carried out on a subgroup of 26 participants . Results : Pre- to postintervention analyses indicated MBSR to provide significantly greater benefits than the control intervention on most dimensions , including visual analog pain , QoL subscales , coping with pain , anxiety , depression and somatic complaints ( Cohen d effect size , 0.40–1.10 ) . Three-year follow-up analyses of MBSR participants indicated sustained benefits for these same measures ( effect size , 0.50–0.65 ) . Conclusions : Based upon a quasi-r and omized trial and long-term observational follow-up , results indicate mindfulness intervention to be of potential long-term benefit for female fibromyalgia patients & NA ; Mindfulness‐based stress reduction ( MBSR ) is a structured 8‐week group program teaching mindfulness meditation and mindful yoga exercises . MBSR aims to help participants develop nonjudgmental awareness of moment‐to‐moment experience . Fibromyalgia is a clinical syndrome with chronic pain , fatigue , and insomnia as major symptoms . Efficacy of MBSR for enhanced well‐being of fibromyalgia patients was investigated in a 3‐armed trial , which was a follow‐up to an earlier quasi‐r and omized investigation . A total of 177 female patients were r and omized to one of the following : ( 1 ) MBSR , ( 2 ) an active control procedure controlling for nonspecific effects of MBSR , or ( 3 ) a  wait list  . The major outcome was health‐related quality of life ( HRQoL ) 2 months post‐treatment . Secondary outcomes were disorder‐specific quality of life , depression , pain , anxiety , somatic complaints , and a proposed index of mindfulness . Of the patients , 82 % completed the study . There were no significant differences between groups on primary outcome , but patients overall improved in HRQoL at short‐term follow‐up ( P = 0.004 ) . Post hoc analyses showed that only MBSR manifested a significant pre‐to‐post‐intervention improvement in HRQoL ( P = 0.02 ) . Furthermore , multivariate analysis of secondary measures indicated modest benefits for MBSR patients . MBSR yielded significant pre‐to‐post‐intervention improvements in 6 of 8 secondary outcome variables , the active control in 3 , and the wait list in 2 . In conclusion , primary outcome analyses did not support the efficacy of MBSR  in fibromyalgia , although patients in the MBSR arm appeared to benefit most . Effect sizes were small compared to the earlier , quasi‐r and omized investigation . Several method ological aspects are discussed , e.g. , patient burden , treatment preference and motivation , that may provide explanations for differences . In a 3‐armed r and omized controlled trial in female patients suffering from fibromyalgia , patients benefited modestly from a mindfulness‐based stress reduction intervention Customized foot orthotics are widely prescribed for patients with chronic , non-specific low back pain and lower limb pain , but there are few trials demonstrating effectiveness , and none for fibromyalgia . A total of 67consecutive patients presenting with chronic , widespread pain , who met the 1990 American College of Rheumatology criteria for fibromyalgia , were included in the study . A total of 32 subjects were prescribed a spinal exercise therapy program along with analgesics . These subjects formed the Control group . A second group , comprised of 35 subjects , received the same therapy , along with customized foot orthotics ( Orthotics group ) . All subjects completed the Revised Fibromyalgia Impact Question naire ( FIQR ) at the initiation of the study and at 8 weeks follow-up . The number of subjects using any type of prescription analgesic or other medication for chronic pain at baseline and at 8 weeks was also recorded . A total of 30 subjects in the Control group and 33 in the Orthotics group completed the study . All subjects completed the baseline and 8-week FIQR . The two groups were well matched in terms of age ( 45.3 ± 11.5 years in the Orthotics group vs. 47.2 ± 8.7 years in the cohort Control ) ,  medication use , duration of pain ( 6.5 ± 4.3 years in the Orthotics group vs. 6.2 ± 3.4 years in the cohort Control group ) , as well as baseline FIQR scores ( 55.2 ± 11.0 in the Orthotics group vs. 56.3 ± 12.2 in the cohort Control group ) . At 8 weeks , the Orthotics group had a greater reduction in the FIQR score than the cohort Control group ( reduction of 9.9 ± 5.9 vs. 4.3 ± 4.4 , respectively ) , and this was mainly due to changes in the ‘ function ’ domain of the FIQR ( reduction of 19.6 ± 9.4 in the Orthotics group vs. 8.1 ± 4.3 in the cohort Control group ) . As part of a complex intervention , in a cohort-controlled trial of primary care patients with fibromyalgia , the addition of custom-made foot orthotics to usual care appears to improve functioning in the short term OBJECTIVES To examine the effects of a challenge with monosodium glutamate ( MSG ) as compared to placebo on the symptoms of fibromyalgia ( FM ) , in participants who initially experienced > 30 % remission of symptoms on an excitotoxin elimination diet . METHODS Fifty-seven FM patients who also had irritable bowel syndrome ( IBS ) were placed on a 4-week diet that excluded dietary additive excitotoxins including MSG and aspartame .  Thirty-seven people completed the diet and 84 % of those reported that > 30 % of their symptoms resolved , thus making them eligible to proceed to challenges . Subjects who improved on the diet were then r and omised to a 2-week double-blind placebo-controlled crossover challenge with MSG or placebo for 3 consecutive days each week . The primary outcome measure was total symptom score . Secondary outcome measures included visual analogue pain scales ( VAS for FM and IBS ) , an IBS Quality of Life Question naire ( IBS QOL ) and the Fibromyalgia Impact Question naire-Revised ( FIQR ) . Repeated measures ANOVA was used to analyse crossover challenge results . RESULTS The MSG challenge , as compared to placebo , result ed in a significant return of symptoms ( total symptom score , p<0.02 ) ; a worsening of fibromyalgia severity as determined by the FIQR ( p<0.03 ) ; decreased quality of life in regards to IBS symptoms ( IBS QOL , p<0.05 ) ; and a non-significant trend toward worsening FM pain based on visual analogue scale ( VAS , p<0.07 ) . CONCLUSIONS These findings suggest that dietary glutamate may be contributing to FM symptoms in some patients . Future research on the role of dietary excitotoxins in FM is warranted OBJECTIVE To test the short and longterm benefits of an 8 week mind-body intervention that combined training in mindfulness meditation with Qigong movement therapy for individuals with fibromyalgia syndrome ( FM ) . METHODS A total of 128 individuals with FM were r and omly assigned to the mind-body training program or an education support group that served as the control . Outcome measures were pain , disability ( Fibromyalgia Impact Question naire ) , depression , myalgic score ( number and severity of tender points ) , 6 minute walk time , and coping strategies , which were assessed at baseline and at 8 , 16 , and 24 weeks . RESULTS Both groups registered statistically significant improvements across time for the Fibromyalgia Impact Question naire , Total Myalgic Score , Pain , and Depression , and no improvement in the number of feet traversed in the 6 minute walk . However , there was no difference in either the rate or magnitude of these changes between the mind-body training group and the education control group . Salutary changes occurring by the eighth week ( which corresponded to the end of the mind-body and education control group sessions ) were largely maintained by both groups throughout the 6 month followup period . CONCLUSION While both groups showed improvement on a number of outcome variables , there was no evidence that the multimodal mind-body intervention for FM was superior to education and support as a treatment option . Additional r and omized controlled trials are needed before interventions of this kind can be recommended for treatment of FM Objectives Fibromyalgia syndrome ( FMS ) is a chronic disorder defined by widespread muscle pain and multiple tender points . The objectives of this study were to estimate prevalence of comorbidities , healthcare re sources utilization , and costs associated with FMS . Methods A retrospective cohort study was conducted using data from the Quebec provincial health plans ( RAMQ ) for a r and om sample of patients with diagnoses of FMS and a control cohort of patients without FMS , matched for age and gender . Prevalence of comorbidities was estimated . Healthcare re sources consumed by FMS and non-FMS patients were identified in terms of visits to physicians , physician 's interventions , pain-related medications , nonpain-related medications , and hospitalizations . Results A total of 16,010 patients with 2 diagnoses of FMS were identified , and control patients were r and omly selected with a ratio of 1:1 . Incidence of most comorbidities was significantly higher in the FMS group and the chronic disease score ( 3.8 vs. 2.8 ; ANOVA P < 0.001 ) . The proportion of patients with at least 1 comorbidity was 87.4 % in the FMS group and 60.1 % in the control group ( χ2P<0.001 ) . The annual number of visits to physician and physician 's interventions was 25.1 for FMS and 14.8 for non-FMS patients . The amount paid by the RAMQ was significantly higher for patients with FMS ( $ 4065 ) compared with patients without FMS ( $ 2766 ) ( ANOVA P<0.001 ) . Discussion Results of this analysis of the RAMQ data base illustrate the high prevalence of comorbidities among patients with a diagnosis of FMS and strongly indicate that the economic burden of FMS is substantial OBJECTIVE Depressive symptoms are common among patients with fibromyalgia , and behavioral intervention has been recommended as a major treatment component for this illness . The objective of this study was to test the effects of the Mindfulness-Based Stress Reduction ( MBSR ) intervention on depressive symptoms in patients with fibromyalgia . METHODS This r and omized controlled trial examined effects of the 8-week MBSR intervention on depressive symptoms in 91 women with fibromyalgia who were r and omly assigned to treatment ( n = 51 ) or a waiting-list control group ( n = 40 ) . Eligible patients were at least 18 years old , willing to participate in a weekly group , and able to provide physician verification of a fibromyalgia diagnosis . Of 166 eligible participants who responded to local television news publicizing , 49 did not appear for a scheduled intake , 24 enrolled but did not provide baseline data , and 2 were excluded due to severe mental illness , leaving 91 participants . The sample averaged 48 years of age and had 14.7 years of education . The typical participant was white , married , and employed . Patients r and omly assigned to treatment received MBSR . Eight weekly 2.5-hour sessions were led by a licensed clinical psychologist with mindfulness training .  Somatic and cognitive symptoms of depression were assessed using the Beck Depression Inventory administered at baseline , immediately postprogram , and at followup 2 months after the conclusion of the intervention . RESULTS Change in depressive symptoms was assessed using slopes analyses of intervention effects over time . Depressive symptoms improved significantly in treatment versus control participants over the 3 assessment s. CONCLUSION This meditation-based intervention alleviated depressive symptoms among patients with fibromyalgia OBJECTIVE To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia , irritable bowel syndrome , and chronic fatigue syndrome , defined as bodily distress syndrome ( BDS ) . METHODS We r and omized 119 patients to either mindfulness therapy ( mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS )  or to enhanced treatment as usual ( 2-hour specialist medical care and brief cognitive behavioral therapy for BDS ) . The primary outcome measure was change in physical health ( SF-36 Physical Component Summary ) from baseline to 15-month follow-up . RESULTS The study is negative as we could not demonstrate a different development over time for the two groups ( F(3,2674)=1.51 , P=.21 ) . However , in the mindfulness therapy group , improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up , whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up . The change scores averaged half a st and ard deviation which amounts to a clinical ly significant change , 29 % changed more than 1 st and ard deviation . Significant between-group differences were observed at treatment cessation . CONCLUSION Mindfulness therapy is a feasible and acceptable treatment . The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms . Nevertheless , considering the more rapid improvement following mindfulness , mindfulness therapy may be a potentially useful intervention in BDS patients . Clinical ly important changes that seem to be comparable to a CBT treatment approach were obtained . Further research is needed to replicate or even exp and these findings
target: No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales .
  Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions .
  Baseline values for the observe subscale of the FFMQ were unexpectedly high .
background: CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia .
  A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials .
  The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .