Cognitive-Behavioral and Personal Construct Therapies for Depression in Women with Fibromyalgia: A Randomized Controlled Trial

Mari Aguilera; Clara Paz; Marta Salla; Victoria Compañ; Joan Carles Medina; Leticia Medeiros-Ferreira; Guillem Feixas

doi:10.1016/j.ijchp.2022.100296

Cognitive-Behavioral and Personal Construct Therapies for Depression in Women with Fibromyalgia: A Randomized Controlled Trial

Int J Clin Health Psychol. 2022 May-Aug;22(2):100296. doi: 10.1016/j.ijchp.2022.100296. Epub 2022 Feb 23.

Authors

Mari Aguilera^{1

2

3}, Clara Paz⁴, Marta Salla⁵, Victoria Compañ⁵, Joan Carles Medina^{2

5

6}, Leticia Medeiros-Ferreira⁷, Guillem Feixas^{2

5}

Affiliations

¹ Department of Cognition, Development and Educational Psychology, Section of Cognitive Processes, Psychology Faculty, Universitat de Barcelona, Spain.
² The Institute of Neurosciences, Universitat de Barcelona, Spain.
³ NeuroDevelop eHealth Lab, eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain.
⁴ School of Psychology and Education, Universidad de Las Américas, Quito, Ecuador.
⁵ Department of Clinical Psychology and Psychobiology, Section of Personality, Evaluation and Psychological Treatment, Psychology Faculty, Universitat de Barcelona, Spain.
⁶ Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Spain.
⁷ Nou Barris Nord Adult Mental Health Centre, Spain.

Abstract
in English, Spanish

Background/objective: Fibromyalgia is a chronic pain syndrome that depressive symptoms can aggravate. The aim of the present study was to test the efficacy of Personal Construct Therapy (PCT), an approach that emphasizes identity features and interpersonal meanings as the focus of the treatment of depressive symptoms, in women with fibromyalgia.

Method: We compared PCT with Cognitive Behavioral Therapy (CBT) in a multicenter parallel randomized trial. Women with fibromyalgia and depressive symptoms (n = 106) were randomly allocated to CBT (n = 55) or PCT (n = 51) in individual and modular formats to adjust to their needs. Analysis was by linear mixed-effects models.

Results: Participants in both conditions had significantly reduced depressive symptoms, and we found no significant difference when comparing groups both post-treatment (β = -0.47, t = -0.49, p = .63) and at follow-up (β = -1.12, t = -1.09, p = .28). Results were similar between conditions for anxiety, fibromyalgia's impact, and the distribution of clinically significant changes in depressive symptoms and pain.

Conclusions: PCT and CBT seem to be equally effective in the treatment of depressive symptoms, making PCT a viable alternative treatment.

Antecedentes/objetivo: La fibromialgia es un trastorno de dolor crónico que los síntomas depresivos agravan. El objetivo del estudio es probar la eficacia de la Terapia de Constructos Personales (TCP), aproximación que enfatiza las características identitarias y los significados personales como foco de la intervención, para el tratamiento de síntomas depresivos en mujeres con fibromialgia.

Método: Comparamos la TCP con la Terapia Cognitivo-Conductual (TCC) en un ensayo multicéntrico paralelo aleatorizado. Mujeres con fibromialgia y síntomas depresivos (n = 106) fueron aleatorizadas a TCC (n = 55) o TCP (n = 51), en formato individual y modular para ajustarse a las necesidades de las pacientes. Los datos se analizaron usando modelos lineales de efectos mixtos.

Resultados: Ambas condiciones redujeron significativamente los síntomas depresivos sin encontrarse diferencias significativas después del tratamiento (β = -0,47, t = -0,49, p = 0,63) ni en el seguimiento (β = -1,12, t = -1,09, p = 0,28). Resultados similares se encontraron para la ansiedad, el impacto de la fibromialgia, la distribución del cambio clínicamente significativo para los síntomas depresivos y el dolor.

Conclusiones: La TCP y la TCC parecerían ser igualmente efectivas para el tratamiento de los síntomas depresivos, postulando la TCP como una alternativa de tratamiento.

Keywords: Case conceptualization; Cognitive therapies; Experiment; Pain; Self-identity.

Abstract in English, Spanish

Abstract
in English, Spanish