Mindfulness-Based Stress Reduction (MBSR) plus usual care reduces functional impairment in fibromyalgia more than usual care alone, both immediately after treatment (large effects) and at 12-month follow-up (medium to large effects). MBSR also outperforms a multicomponent intervention (FibroQoL) plus usual care at post-treatment (medium to large effects), but long-term advantages are modest, limited to less pain catastrophising and fibromyalginess. The number needed to treat for a 20% improvement post-treatment is 4.0 for MBSR versus usual care and 5.0 for MBSR versus FibroQoL. Improvements in functional impact are mediated by reduced psychological inflexibility and increased acting with awareness.
Mindfulness-Based Stress Reduction (MBSR) reduced clinical severity in female fibromyalgia patients and prevented a decline in the anti-inflammatory cytokine IL-10 that occurred in the treatment-as-usual group. Higher baseline levels of the chemokine CXCL8 weakened MBSR's beneficial effects on pain, energy, stiffness, and sleep quality. Higher baseline ratios of pro-inflammatory IL-6/IL-10 and CXCL8/IL-10 were linked to less improvement in psychological inflexibility after MBSR. The authors propose that immune biomarkers may help predict who responds to MBSR.
This 12-month randomized controlled trial will test whether adding Mindfulness-Based Stress Reduction (MBSR) to usual care for fibromyalgia syndrome (FMS) is more effective and cost-effective than usual care plus a psychoeducational program (FibroQoL) or usual care alone. The study will enroll 180 adult FMS patients and measure functional, quality of life, distress, and cost outcomes, along with brain structure and function (via MRI) and inflammatory markers (IL-6, IL-8, IL-10, and high-sensitivity CRP) in half the participants. The results are expected to clarify whether MBSR produces brain and inflammatory changes and whether it is a cost-effective add-on therapy for FMS.