Análisis comparativo de la eficacia de dos terapias psicológicas para remitir la depresión en mujeres con fibromialgia
PDF

Palabras clave

Comparison
Psychological therapies
Reduction
Depression
Fibromyalgia Comparación
Terapias psicológicas
Reducción
Depresión
Fibromialgia

Resumen

Introducción. La fibromialgia es una enfermedad reumática crónica cuya principal característica es un dolor agudo y persistente en la mayor parte del cuerpo. Se ha demostrado que los síntomas de depresión en pacientes con fibromialgia puede empeorar el curso de la enfermedad y acentuar el dolor. El objetivo del presente estudio fue comparar el efecto de dos terapias psicológicas para reducir la sintomatología depresiva en 27 mujeres con fibromialgia. Método. Las participantes fueron asignadas aleatoriamente a la terapia de compasión basada en los estilos de apego (ABCT) o a la terapia de aceptación y compromiso (ACT). Se administró a las participantes la DASS-D, una escala que mide depresión en tres momentos temporales: antes, después y a los tres meses de concluido el tratamiento. Se llevó a cabo un análisis de varianza con medidas repetidas mediante el programa SPSS. Resultados. La reducción de la depresión después del tratamiento fue significativamente mayor en el grupo ABCT que en el grupo ACT, manteniéndose este efecto a los tres meses de seguimiento. Discusión y conclusiones. Al parecer, la ABCT es un tratamiento más eficaz que la ACT para reducir los síntomas depresivos en pacientes con fibromialgia.

https://doi.org/10.25009/pys.v34i1.2843
PDF

Citas

Amutio, A., Franco, C., Pérez F., M.C., Gázquez, J.J. y Mercader, I. (2015). Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients. Frontiers in Psychology, 5, 1572. Doi: 10.3389/fpsyg.2014.01572

Bados, A., Solanas, A. y Andrés, R. (2005). Psychometric properties of the Spanish version of Depression, Anxiety and Stress Scales (DASS). Psicothema, 17(4), 679-683.

Bernardy, K., Füber, N., Köllner, V. y Häuser, W. (2010). Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome: A systematic review and metaanalysis of randomized controlled trials. The Journal of Rheumatology, 37(10), 1991-2005. Doi: 10.3899/jrheum.100104

Breines, J.G. y Chen, S. (2012). Self-compassion increases self-improvement motivation. Personality and Social Psychology Bulletin, 38(9), 1133-1143. Doi: 10.1177/0146167212445599

Brown, T.A., Chorpita, B.F., Korotitsch, W. y Barlow, D.H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35(1), 79-89. Doi: 10.1016/S0005-7967(96)00068-X

Cabo M., A., Cerdá O., G. y Trillo M., J.L. (2017). Fibromialgia: Prevalencia, perfiles epidemiológicos y costes económicos. Medicina Clínica, 149(10), 441-448. Doi: 10.1016/j.medcli.2017.06.008

Chang, E.C., Lucas, A.G., Chang, O.D., Angoff, H.D., Li, M., Duong, A.H., Huang, J., Perera, M.J., Sirois, F.M. y Hirsch, J.K. (2019). Relationship between future orientation and pain severity in fibromyalgia patients: Self-compassion as a coping mechanism. Social Work, 64(3), 253-258. Doi: 10.1093/sw/swz013

Charles, S.T. y Carstensen, L.L. (2014). Emotion regulation and aging. En J. J. Gross (Ed.): Handbook of emotion regulation (pp. 203-218). The Guilford Press.

Cruz A., C., Cuerda M., D.C., Sabadell M., D.E., García M., T.F., Ruiz V., G., López J., M., Mira M., Á.P., de Salazar B., R.O. y Amores R., S. (2011). Fibromialgia. Madrid: Ministerio de Sanidad, Política Social e Igualdad.

Davis, M.C., Thummala, K. y Zautra, A.J. (2014). Stress-related clinical pain and mood in women with chronic pain: Moderating effects of depression and positive mood induction. Annals of Behavioral Medicine, 48(1), 61-70. Doi: 10.1007/s12160-013-9583-6

Fearon, R.M.P. y Roisman, G.I. (2017). Attachment theory: Progress and future directions. Current Opinion in Psychology, 15, 131-136. Doi: 10.1016/j.copsyc.2017.03.002

García C., J., Navarro G., M. y Demarzo, M. (2016). Attachment-based compassion therapy. Mindfulness & Compassion, 1(2), 68-74. Doi: 10.1016/j.mincom.2016.10.004

Geenen, R., Jacobs, J.W.G. y Bijlsma, J.W.J. (2002). Evaluation and management of endocrine dysfunction in fibromyalgia. Rheumatic Disease Clinics, 28(2), 389-404. Doi: 10.1016/S0889-857X(01)00009-6

Germer, C.K. (2009). The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions. The Guilford Press.

Germer, C.K. y Neff, K.D. (2013). Self-compassion in clinical practice. Journal of Clinical Psychology, 69(8), 856-867. Doi: 10.1002/jclp.22021

Gilbert, P. (2010). Compassion focused therapy: Distinctive features. Routledge.

Hayes, S.C., Luoma, J.B., Bond, F.W., Masuda, A. y Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25. Doi: 10.1016/j.brat.2005.06.006

Hellström, C., Jansson, B. y Carlsson, S.G. (2000). Perceived future in chronic pain: The relationship between outlook on future and empirically derived psychological patient profiles. European Journal of Pain, 4(3), 283-290. Doi: 10.1053/eujp.2000.0184

Hollis-Walker, L. y Colosimo, K. (2011). Mindfulness, self-compassion, and happiness in non-mediators: A theoretical and empirical examination. Personality and Individual Differences, 50(2), 222-227. Doi: 10.1016/j.paid.2010.09.033

Lindsay, E.K. y Creswell, J.D. (2017). Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT). Clinical Psychology Review, 51, 48-59. Doi: 10.1016/j.cpr.2016.10.011

López, A., Sanderman, R. y Schroevers, M.J. (2016). Mindfulness and self-compassion as unique and common predictors of affect in the general population. Mindfulness, 7(6), 1289-1296. Doi: 10.1007/s12671-016-0568-y

Luciano, J.V., Guallar, J.A., Aguado, J., López H., Y., Olivan, B., Magallón, R., Alda, M., Serrano B., A., Gili, M. y Garcia C., J. (2014). Effectiveness of group acceptance and commitment therapy for fibromyalgia: A 6-month randomized controlled trial (EFFIGACT study). Pain, 155(4), 693-702. Doi: 10.1016/j.pain.2013.12.029

Mauchly, J.W. (1940). Significance test for sphericity of a normal n-variate distribution. The Annals of Mathematical Statistics, 11(2), 204-209. Doi:10.1214/aoms/1177731915.JSTOR 2235878

Miró, E., Diener F., N., Martínez M., P., Sánchez A., I. y Valenza M., C. (2012). La fibromialgia en hombres y mujeres: comparación de los principales síntomas clínicos. Psicothema, 24(1), 10-15.

Montero M., J., Navarro G., M., Puebla G., M., Luciano, J.V., Van Gordon, W., Shonin, E. y García C., J. (2018). Efficacy of “attachment-based compassion therapy” in the treatment of fibromyalgia: A randomized controlled trial. Frontiers in Psychiatry, 8, 307. Doi: 10.3389/fpsyt.2017.00307

Montero M., J., Van Gordon, W., Shonin, E., Navarro G., M., Gasión, V., López H., Y., Luciano J., V. y Garcia C., J. (2020). Attachment-based compassion therapy for ameliorating fibromyalgia: Mediating role of mindfulness and self-compassion. Mindfulness, 11(3), 816-828. Doi: 10.1007/s12671-019-01302-8

Morea, J.M., Friend, R. y Bennett, R.M. (2008). Conceptualizing and measuring illness self-concept: A comparison with self-esteem and optimism in predicting fibromyalgia adjustment. Research in Nursing & Health, 31(6), 563-575. Doi: 10.1002/nur.20294

Navarro G., M., Lopez H., Y., Modrego A., M., Montero M., J., Van Gordon, W., Shonin, E. y Garcia C., J. (2020). Effects of attachment-based compassion therapy (ABCT) on self-compassion and attachment style in healthy people. Mindfulness, 11(1), 51-62. Doi: 10.1007/s12671-018-0896-1

Neff, K.D. y Dahm, K.A. (2015). Self-compassion: What it is, what it does, and how it relates to mindfulness. En B. D. Ostafin, M. D. Robinson y B. P. Meier (Eds.): Handbook of mindfulness and self-regulation (pp. 121-140). Springer. Doi: 10.1007/978-1-4939-2263-5_10

Neff, K.D., Rude, S.S. y Kirkpatrick, K.L. (2007). An examination of self-compassion in relation to positive psychological functioning and personality traits. Journal of Research in Personality, 41(4), 908-916. Doi: 10.1016/j.jrp.2006.08.002

Phillips, W.J. y Ferguson, S.J. (2013). Self-compassion: A resource for positive aging. The Journal of Gerontology: Series B, 68(4), 529-539. Doi: 10.1093/geronb/gbs091

Purdie, F. y Morley, S. (2016). Compassion and chronic pain. Pain, 157(12), 2625-2627. Doi: 10.1097/j.pain.0000000000000638

Ruiz F., J., García M., M.B., Suárez F., J.C. y Odriozola G., P. (2017). The hierarchical factor structure of the Spanish version of the Depression Anxiety and Stress Scale-21. International Journal of Psychology & Psychological Therapy, 17(1), 97-105.

Santos, A., Crespo, I., Pérez A., A., Beltrán R., M., Puebla G., M. y García C., J. (2022). Attachment-based compassion therapy for reducing anxiety and depression in fibromyalgia. International Journal of Environmental Research and Public Health, 19(13), 8152. Doi: 10.3390/ijerph19138152

Sayar, K., Gulec, H. y Topbas, M. (2004). Alexithymia and anger in patients with fibromyalgia. Clinical Rheumatology, 23, 441-448. Doi: 10.1007/s10067-004-0918-3

Thieme, K., Mathys, M. y Turk, D.C. (2017). Evidenced-based guidelines on the treatment of fibromyalgia patients: Are they consistent, and if not, why not? Have effective psychological treatments been overlooked? The Journal of Pain, 18(7), 747-756. Doi: 10.1016/j.jpain.2016.12.006

Uclés J., R., Fernández C., D., Fernández M., S. y Díaz A., J.C. (2020). Conceptuación de la fibromialgia: ¿Consenso o discrepancia entre profesionales clínicos de España? Revista Española de Salud Pública, 94, e202001006. Doi: 10.4321/S1135-57272020000100018

van Ittersum, M.W., van Wilgen, C.P., Hilberdink, W.K.H.A., Groothoff, J.W. y van der Schans, C.P. (2009). Illness perceptions in patients with fibromyalgia. Patient Education and Counseling, 74(1), 53-60. Doi: 10.1016/j.pec.2008.07.041

van Middendorp, H., Lumley, M.A., Houtveen, J.H., Jacobs, J.W.G., Bijlsma, J.W.J. y Geenen, R. (2013). The impact of emotion-related autonomic nervous system responsiveness on pain sensitivity in female patients with fibromyalgia. Psychosomatic Medicine, 75(8), 765-773. Doi: 10.1097/psy.0b013e3182a03973

Vincent, A., Benzo, R.P., Whipple, M.O., McAllister, S.J., Erwin, P.J. y Saligan, L.N. (2013). Beyond pain in fibromyalgia: Insights into the symptom of fatigue. Arthritis: Research & Therapy, 15, 221. Doi: 10.1186/ar4395

Vincent, A., Whipple, M.O., McAllister, S.J., Aleman, K.M. y Sauver, J.L.S. (2015). A cross-sectional assessment of the prevalence of multiple chronic conditions and medication use in a sample of community-dwelling adults with fibromyalgia in Olmsted County, Minnesota. BMJ Open, 5(3), e006681. Doi: 10.1136/bmjopen-2014-006681

Wei, M., Liao, K. y .‐H., Ku, T.‐Y. y Shaffer, P.A. (2011). Attachment, self-compassion, empathy, and subjective well-being among college students and community adults. Journal of Personality, 79(1), 191-221. Doi: 10.1111/j.1467-6494.2010.00677.x

Wolfe, F., Clauw, D.J., Fitzcharles, M.A., Goldenberg, D.L., Katz, R.S., Mease, P., Russell, A.S., Russell, I.J., Winfield, J.B. y Yunus, M.B. (2010). The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care & Research, 62(5), 600-610. Doi: 10.1002/acr.20140

Yim, Y.-R., Lee, K.-E., Park, D.-J., Kim, S.-H., Nah, S.-S., Lee, J.H., Kim, S.-K., Lee, Y.-A., Hong, S.-J., Kim, H.-S., Lee, H.-S., Kim, H.A., Joung, C.-I., Kim, S.-H. y Lee, S.-S. (2016). Identifying fibromyalgia subgroups using cluster analysis: Relationships with clinical variables. European Journal of Pain, 21(2), 374-384. Doi: 10.1002/ejp.935

Zessin, U., Dickhäuser, O. y Garbade, S. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340-364. Doi: 10.1111/aphw.12051