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Efficacy of Combined Cognitive-Behavioral Therapy for Insomnia and Pain in Patients with Fibromyalgia: A Randomized Controlled Trial

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Abstract

This controlled trial aims to analyze the efficacy of cognitive-behavioral therapy for insomnia and pain (CBT-IP) compared to cognitive-behavioral therapy for pain (CBT-P) and usual medical care (UMC) at improving sleep and other clinical manifestations (pain, fatigue, impaired functioning, and emotional distress) in women with fibromyalgia (FM). One hundred and twenty-six patients with FM were randomly assigned to different treatment groups and 113 completed the treatments (38 in the CBT-IP group, 34 in the CBT-P group and 41 in the UMC group) and a number of self-reports at pre-treatment, post-treatment, and 3 months of follow-up. The CBT-IP group showed significant improvements at post-treatment in several sleep variables (i.e., subjective sleep quality, sleep latency, sleep efficiency, and use of sleeping medication) that were not observed in the CBT-P and UMC groups. The CBT-IP and CBT-P groups reported significant improvements at post-treatment in FM impact and self-efficacy for coping with pain; the CBT-IP group reported improvements at follow-up in pain intensity, and the CBT-P reported improvements at post-treatment in pain catastrophizing and pain acceptance. Clinical improvements are also described. The findings revealed differential responses between groups regarding sleep and other adjustment parameters and the CBT-IP group exhibited the best clinical response pattern overall. More research in the area of FM treatment is needed to enhance the efficacy of the CBT and identify which patients are likely to benefit from each modality of CBT.

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References

  • Alegre de Miquel, C., Campayo, J.G., Flórez, M.T., Arguelles, J. M. G., Tarrio, B.E., & Montoya, M.G. (2010). Documento de consenso interdisciplinar para el tratamiento de la fibromialgia [Interdisciplinary consensus document for the treatment of fibromyalgia]. Actas Españolas de Psiquiatría, 38, 108–120.

    Google Scholar 

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th. ed. rev.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Anderson, K. O., Dowds, B. N., Pelletz, R. E., Edwards, W. T., & Peeters-Asdourian, C. (1995). Development and initial validation of a scale to measure self-efficacy beliefs in patients with chronic pain. Pain, 63, 77–84. doi:10.1016/0304-3959(95)00021-J

    Article  CAS  PubMed  Google Scholar 

  • Belt, N. K., Kronholm, E., & Kauppi, M. J. (2009). Sleep problems in fibromyalgia and rheumatoid arthritis compared with the general population. Clinical and Experimental Rheumatology, 27, 35–41.

    CAS  PubMed  Google Scholar 

  • Bernardy, K., Fueber, N., Koellner, V., & Häuser, W. (2010). Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome: A systematic review and meta-analysis of randomized controlled trials. The Journal of Rheumatology, 37, 1991–2005. doi:10.3899/jrheum.100104

    Article  PubMed  Google Scholar 

  • Branco, J. C., Bannwarth, B., Failde, I., Abello Carbonell, J., Blotman, F., Spaeth, M., & …Matucci-Cerinic, M. (2010). Prevalence of fibromyalgia: A survey in five European countries. Seminars in Arthritis and Rheumatism, 39, 448–453. doi:10.1016/j.semarthrit.2008.12.003

    Article  PubMed  Google Scholar 

  • Bryson, J., Read, J. B., Bush, J., & Edwards, C. L. (2014). A Clinical intervention in chronic pain and insomnia with a combined model of treatment: A test of concept. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32, 279–296. doi:10.1007/s10942-014-0194-3

    Article  Google Scholar 

  • Burckhardt, C., Clark, S., & Bennet, R. (1991). The fibromyalgia Impact questionnaire: development and validation. The Journal of Rheumatology, 18, 728–734.

    CAS  PubMed  Google Scholar 

  • Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.

    Article  CAS  PubMed  Google Scholar 

  • Canivet, C., Ostergren, P. O., Choi, B., Nilsson, P., af Sillén, U., Moghadassi, M., . . . & Isacsson, S. O. (2008). Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: Results from a one year follow-up of the Malmo Shoulder Neck Study Cohort. International Journal of Behavioral Medicine, 15, 254–262. doi:10.1080/10705500802365466.

    Article  PubMed  Google Scholar 

  • Clauw, D. J. (2014). Fibromyalgia: A clinical review. JAMA: The Journal of the American Medical Association, 311, 1547–1555. doi:10.1001/jama.2014.3266.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavior sciences (2nd edn.). Hillsdale: Lawrence Erlbaum.

    Google Scholar 

  • Cole, J. C., Dubois, D., & Kosinski, M. (2007). Use of patient-reported sleep measures in clinical trials of pain treatment: A literature review and synthesis of current sleep measures and a conceptual model of sleep disturbance in pain. Clinical Therapeutics, 29, 2580–2588. doi:10.1016/j.clinthera.2007.12.005.

    Article  PubMed  Google Scholar 

  • Currie, S. R., Wilson, K. G., Pontefract, A. J., & deLaplante, L. (2000). Cognitive-behavioral treatment of insomnia secondary to chronic pain. Journal of Consulting and Clinical Psychology, 68, 407–416. doi:10.1037/0022-006X.68.3.407

    Article  CAS  PubMed  Google Scholar 

  • Derogatis, L. R. (2002). SCL-90-R. Cuestionario de 90 síntomas. [SCL-90-R. Symptom checklist 90 revised]. Madrid: TEA Ediciones.

    Google Scholar 

  • Díaz-Piedra, C., Di Stasi, L. L., Baldwin, C. M., Buela-Casal, G., & Catena, A. (2015). Sleep disturbances of adult women suffering from fibromyalgia: A systematic review of observational studies. Sleep Medicine Reviews, 21, 86–99. doi:10.1016/j.smrv.2014.09.001

    Article  PubMed  Google Scholar 

  • Edinger, J. D., Wohlgemuth, W. K., Krystal, A. D., & Rice, J. R. (2005). Behavioral insomnia therapy for fibromyalgia patients: A randomized clinical trial. Archives of Internal Medicine, 165, 2527–2535. doi:10.1001/archinte.165.21.2527.

    Article  PubMed  Google Scholar 

  • Fillion, L., Gélinas, C., Simard, S., Savard, J., & Gagnon, P. (2003). Validation evidence for the French Canadian adaptation of the multidimensional fatigue inventory as a measure of cancer-related fatigue. Cancer Nursing, 26, 143–154.

    Article  PubMed  Google Scholar 

  • Finan, P. H., Buenaver, L., Coryell, V. T., & Smith, M. (2014). Cognitive-behavioral therapy for comorbid insomnia and chronic pain. Sleep Medicine Clinics, 9, 261–274. doi:10.1016/j.jsmc.2014.02.007

    Article  PubMed  PubMed Central  Google Scholar 

  • Fitzcharles, M., & Yunus, M. (2012). The clinical concept of fibromyalgia as a changing paradigm in the past 20 years. Pain Research and Treatment. doi:10.1155/2012/184835

    PubMed Central  Google Scholar 

  • García-Campayo, J., Rodero, R., Alda, M., Sobradiel, N., Montero, J., & Moreno, S. (2008). Validación de la versión española de la Escala de la Catastrofización ante el Dolor (Pain Catastrophizing Scale) en la fibromialgia [Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia]. Medicina Clínica, 131, 487–492. doi:10.1157/13127277.

    Article  PubMed  Google Scholar 

  • Glombiewski, J. A., Sawyer, A. T., Gutermann, J., Koenig, K., Rief, W., & Hofmann, S. G. (2010). Psychological treatments for fibromyalgia: A meta-analysis. Pain, 151, 280–295. doi: 10.1016/j.pain.2010.06.011

    Article  PubMed  Google Scholar 

  • Hamilton, N. A., Catley, D., & Karlson, C. (2007). Sleep and the affective response to stress and pain. Health Psychology, 26, 288–295. doi: 10.1037/0278-6133.26.3.288

    Article  PubMed  Google Scholar 

  • Harvey, A. (2005). A cognitive theory and therapy for chronic insomnia. Journal of Cognitive Psychotherapy: An International Quarterly, 19, 41–59. doi:10.1891/jcop.19.1.41.66332

    Article  Google Scholar 

  • Häuser, W., Thieme, K., & Turk, D. C. (2010). Guidelines on the management of fibromyalgia syndrome: A systematic review. European Journal of Pain, 14, 5–10. doi:10.1016/j.ejpain.2009.01.006

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. doi:10.1037//0022-006X.59.1.12

    Article  CAS  PubMed  Google Scholar 

  • Jungquist, C. R., O’Brien, C., Matteson-Rusby, S., Smith, M. T., Pigeon, W. R., Xia, Y., & Perlis, M. L. (2010). The efficacy of cognitive behavioral therapy for insomnia in patients with chronic pain. Sleep Medicine, 11, 302–309. doi:10.1016/j.sleep.2009.05.018.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kim, Y. (2011). Missing data handling in chronic pain trials. Journal of Biopharmaceutical Statistics, 21, 311–325. doi: 10.1080/10543406.2011.550112

    Article  CAS  PubMed  Google Scholar 

  • Lázaro, C., Caseras, X., Whizar-Lugo, V. M., Wenk, R., Baldioceda, F., Bernal, R.,. . .& Baños, J. E. (2001). Psychometric properties of a Spanish version of the McGill pain questionnaire in several Spanish-speaking countries. The Clinical Journal of Pain, 17, 365–374.

    Article  PubMed  Google Scholar 

  • Lee, Y. C., Nassikas, N. J., & Clauw, D. J. (2011). The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis Research and Therapy, 13, 211. doi:10.1186/ar3306

    Article  PubMed  PubMed Central  Google Scholar 

  • Leeuw, M., Goossens, M., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2007). The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30, 77–94. doi:10.1007/s10865-006-9085-0

    Article  PubMed  Google Scholar 

  • Martín-Aragón, M., Pastor, M. A., Rodríguez-Marín, J., March, M. J., Lledó, A., López-Roig, S., & Terol, M. C. (1999). Percepción de autoeficacia en dolor crónico: Adaptación y validación de la chronic pain self-efficacy scale [Perceived self-efficacy in chronic pain: Adaptation and validation of the chronic pain self-efficacy scale]. Revista de Psicología de la Salud, 11, 53–75.

    Google Scholar 

  • Martínez, M. P., Miró, E., & Sánchez, A. I. (2014b). Tratamiento psicológico del insomnio en la fibromialgia y otros síndromes de dolor crónico [Psychological treatment of insomnia in fibromyalgia and other chronic pain syndromes]. CM de Psicobioquímica, 3, 39–54.

    Google Scholar 

  • Martínez, M. P., Miró, E., Sánchez, A. I., Díaz-Piedra, C., Cáliz, R., Vlaeyen, J. W. S., & Buela-Casal, G. (2014a). Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: A randomized controlled trial. Journal of Behavioral Medicine, 37, 683–697. doi: 10.1007/s10865-013-9520-y

    Article  PubMed  Google Scholar 

  • Martínez, M. P., Sánchez, A. I., Miró, E., Lami, M. J., Prados, G., & Morales, A. (2015). Relationships between physical symptoms, emotional distress, and pain appraisal in fibromyalgia: The moderator effect of alexithymia. The Journal of Psychology: Interdisciplinary and Applied, 149, 115–140. doi:10.1080/00223980.2013.844673

    Article  Google Scholar 

  • McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: Component analysis and revised assessment method. Pain, 107, 159–166.

    Article  PubMed  Google Scholar 

  • McCurry, S. M., Shortreed, S. M., Von Korff, M., Balderson, B. H., Baker, L. D., Rybarczyk, B. D., & Vitiello, M. V. (2014). Who benefits from CBT for insomnia in primary care? Important patient selection and trial design lessons from longitudinal results of the lifestyles trial. Sleep, 37, 299–308. doi: 10.5665/sleep.3402

    Article  PubMed  PubMed Central  Google Scholar 

  • Melzack, R. (1987). The short form McGill pain questionnaire. Pain, 30, 191–197.

    Article  CAS  PubMed  Google Scholar 

  • Miró, E., Lupiáñez, J., Hita, E., Martínez, M. P., Sánchez, A. I., & Buela-Casal, G. (2011a). Attentional deficits in fibromyalgia and its relationships with pain, emotional distress and sleep dysfunction complaints. Psychology and Health, 26, 765–780. doi: 10.1080/08870446.2010.493611

    Article  PubMed  Google Scholar 

  • Miró, E., Lupiáñez, J., Martínez, M. P., Sánchez, A. I., Díaz-Piedra, C., Guzmán, M. A., & Buela-Casal, G. (2011b). Cognitive-behavioral therapy for insomnia improves attentional function in fibromyalgia syndrome: A pilot, randomized controlled trial. Journal of Health Psychology, 16, 770–782. doi: 10.1177/1359105310390544

    Article  PubMed  Google Scholar 

  • Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J.,. . .& Altman, D. G. (2010). CONSORT 2010. Explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, c869. doi:10.1136/bmj.c869.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moldofsky, H. (2009). The significance of dysfunctions of the sleeping/waking brain to the pathogenesis and treatment of fibromyalgia syndrome. Rheumatic Diseases Clinics of North America, 35, 275–283. doi:10.1016/j.rdc.2009.05.008

    Article  PubMed  Google Scholar 

  • Moldofsky, H. (2010). Rheumatic manifestations of sleep disorders. Current Opinion in Rheumatology, 22, 59–63. doi:10.1097/BOR.0b013e328333b9cc

    Article  PubMed  Google Scholar 

  • Morgenthaler, T., Kramer, M., Alessi, C., Friedman, L., Boehlecke, B., Brown, T.,. .. & Swick, T. (2006). Practice parameters for the psychological and behavioral treatment of insomnia: An update. An American Academy of Sleep Medicine report. Sleep, 29, 1415–1419.

    Article  PubMed  Google Scholar 

  • Morin, C. M. (1998). Insomnio. Asistencia y tratamiento psicológico [Insomnia. Assistance and psychological treatment]. Barcelona: Ariel.

    Google Scholar 

  • Osorio, C. D., Gallinaro, A. L., Lorenzi-Filho, G., & Lage, L. V. (2006). Sleep quality in patients with fibromyalgia using the Pittsburgh sleep quality index. The Journal of Rheumatology, 33, 1863–1865.

    PubMed  Google Scholar 

  • Palagini, L., Carmassi, C., Conversano, C., Gesi, C., Bazzichi, L., Giacomelli, C., & Dell’Osso, L. (2016). Transdiagnostic factors across fibromyalgia and mental disorders: Sleep disturbances may play a key role. A clinical review. Clinical and Experimental Rheumatology, 34, 140–144.

    Google Scholar 

  • Pigeon, W. R., Moynihan, J., Matteson-Rusby, S., Jungquist, C. R., Xia, Y., Tu, X., & Perlis, M. L. (2012). Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: A pilot study. Behaviour Research and Therapy, 50, 685–689. doi:10.1016/j.brat.2012.07.005

    Article  PubMed  PubMed Central  Google Scholar 

  • Prados, G., & Miró, E. (2012). Fibromialgia y sueño: Una revisión [Fibromyalgia and sleep: A review]. Revista de Neurología, 54, 227–240.

    CAS  PubMed  Google Scholar 

  • Prados, G., Miró, E., Martínez, M. P., Sánchez, A. I., Lami, M. J., & Cáliz, R. (in review). Effects of combined cognitive-behavioral therapy on polysomnographic parameters and perceived sleep quality in fibromyalgia women.

  • Rivera, J., & González, T. (2004). The fibromyalgia impact questionnaire: A validated Spanish version to assess the health status in women with fibromyalgia. Clinical and Experimental Rheumatology, 22, 554–560.

    CAS  PubMed  Google Scholar 

  • Rodero, B., García-Campayo, J., Casanueva, B., López del Hoyo, Y., Serrano-Blanco, A., & Luciano, J. V. (2010). Validation of the Spanish version of the chronic pain acceptance questionnaire (CPAQ) for the assessment of acceptance in fibromyalgia. Health and Quality of Life Outcomes, 8, 37. doi:10.1186/1477-7525-8-37

    Article  PubMed  PubMed Central  Google Scholar 

  • Royuela, A., & Macías, J. A. (1997). Propiedades clinimétricas de la versión castellana del cuestionario de Pittsburgh [Clinimetrical properties of the Spanish version of the Pittsburgh questionnaire]. Vigilia-Sueño, 9, 81–94.

    Google Scholar 

  • Rybarczyk, B., Stepanski, E., Fogg, L., López, M., Barry, P., & Davis, A. A. (2005). A placebo-controlled test of cognitive-behavioral therapy for comorbid insomnia in older adults. Journal of Consulting and Clinical Psychology, 73, 1164–1174. doi: 10.1037/0022-006X.73.6.1164

    Article  PubMed  Google Scholar 

  • Salaberría, K., Páez, D., & Echeburúa, E. (1996). Evaluación de la validez del cambio inducido por los tratamientos psicológicos [Assessment of the validity of change induced by psychological treatments]. Boletín de Psicología, 52, 71–96.

    Google Scholar 

  • Sánchez, A. I., Díaz-Piedra, C., Miró, E., Martínez, M. P., Gálvez, R., & Buela-Casal, G. (2012). Effects of cognitive-behavioral therapy for insomnia on polysomnographic parameters in fibromyalgia patients. International Journal of Clinical and Health Psychology, 12, 39–53.

    Google Scholar 

  • Sedgwick, P. (2014). Explanatory trials versus pragmatic trials. BMJ, 14, 349–351. doi: 10.1136/bmj.g6694

    Google Scholar 

  • Smeets, R. J., Vlaeyen, J. W., Kester, A. D., & Knottnerus, J. A. (2006). Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. The Journal of Pain, 7, 261–271. doi: 10.1016/j.jpain.2005.10.011.

    Article  PubMed  Google Scholar 

  • Smets, E. M., Garssen, B., Bonke, B., & De Haes, J. C. (1995). The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research, 39, 315–325. doi:10.1016/0022-3999(94)00125-O

    Article  CAS  PubMed  Google Scholar 

  • Sullivan, M. J. L., Bishop, S., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7, 524–532. doi:10.1037/1040-3590.7.4.524.

    Article  Google Scholar 

  • Tang, N. K. Y., Goodchild, C. E., & Salkovskis (2012). Hybrid cognitive-behaviour therapy for individuals with insomnia and chronic pain: A pilot randomized controlled trial. Behaviour Research and Therapy, 50, 814–820. doi:10.1016/j.brat.2012.08.006

    Article  PubMed  Google Scholar 

  • Thieme, K., Turk, D. C., & Flor, H. (2007). Responder criteria for operant and cognitive behavioral treatment of fibromyalgia syndrome. Arthritis and Rheumatism, 57, 830–836. doi:10.1002/art.22778

    Article  PubMed  Google Scholar 

  • Thomas, R. J. (2011). Sleep as a window into the world of fibromyalgia syndrome. Journal of Rheumatology, 38, 2499–2500. doi:10.3899/jrheum.111314

    Article  PubMed  Google Scholar 

  • Turk, D. C., Vierck, C. J., Scarbrough, E., Crofford, L. J., & Rudin, N. J. (2008). Fibromyalgia: Combining pharmacological and nonpharmacological approaches to treating the person, not just the pain. The Journal of Pain, 9, 99–104. doi: 10.1016/j.jpain.2007.08.006

    Article  PubMed  Google Scholar 

  • van Koulil, S., van Lankveld, W., Kraaimaat, F. W., van Helmond, T., Vedder, A., van Hoorn, H.,. .. & Evers, A. W. (2008). Tailored cognitive-behavioral therapy for fibromyalgia: Two case studies. Patient Education and Counseling, 71, 308–314. doi:10.1016/j.pec.2007.11.025

    Article  PubMed  Google Scholar 

  • Vitiello, M., McCurry, S. M., Shortreed, S., Barker, L., Rybarczyk, B. D., Keefe, F. J., & Von Korff, M. (2014). Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia. Pain, 155, 1547–1554. doi:10.1016/j.pain.2014.04.032

    Article  PubMed  PubMed Central  Google Scholar 

  • Vitiello, M. V., McCurry, S. M., Shortreed, S. M., Balderson, B. H., Baker, L. D., Keefe, F. J.,. .. & Von Korff, M. (2013). Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The lifestyles randomized controlled trial. Journal of the American Geriatrics Society, 61, 947–956. doi: 10.1111/jgs.12275

    Article  PubMed  PubMed Central  Google Scholar 

  • Vitiello, M. V., Rybarczyk, B., Von Korff, M., & Stepanski, E. J. (2009). Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. Journal of Clinical Sleep Medicine, 5, 355–362.

    PubMed  PubMed Central  Google Scholar 

  • Vlaeyen, J. W. S., & Linton, S. J. (2012). Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain, 153, 1144–1147. doi:10.1016/j.pain.2011.12.009

    Article  PubMed  Google Scholar 

  • Von Bülow, C., Amris, K., Bandak, E., Danneskiold-Samsøe, B., & Wæhrens, E. E. (2017). Improving activities of daily living ability in women with fibromyalgia: An exploratory, quasi-randomized, phase-two study, improve trial. Journal of Rehabilitation Medicine, 49, 241–250. doi: 10.2340/16501977-2198

    Article  Google Scholar 

  • Von Korff, M., Vitiello, M., McCurry, S., Balderson, B. H., Moore, A., Baker, L.,. . .& Saunders, K. (2012). Group intervention for co-morbid insomnia and osteoarthritis pain in primary care: The lifestyles cluster randomized trial design. Contemporary Clinical Trials, 33, 759–768. doi:10.1016/j.cct.2012.03.010

    Article  Google Scholar 

  • Wagner, J., DiBonaventura, M. D., Chandran, A. B., & Cappelleri, J. C. (2012). The association of sleep difficulties with health-related quality of life among patients with fibromyalgia. BMC Musculoskeletal Disorders, 13, 199. doi:10.1186/1471-2474-13-199

    Article  PubMed  PubMed Central  Google Scholar 

  • Wolfe, F., Clauw, D. J., Fitzcharles, M. A., Goldenberg, D. L., Katz, R. S., Mease, P.,. .. & Yunus, M. B. (2010). The American college of rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care and Research, 62, 600–610. doi:10.1002/acr.20140

    Article  PubMed  Google Scholar 

  • Wolfe, F., Smythe, H. A., Yunus, M. B., Benett, M. R., Bombardier, C., Goldenberg, D.,. .. & Sheon, R. P. (1990). The American college of rheumatology 1990 criteria for the classification of fibromyalgia: Report of the multicenter criteria committee. Arthritis and Rheumatism, 33, 160–172.

    Article  CAS  PubMed  Google Scholar 

  • Wolfe, F., Walitt, B. T., Katz, R. S., & Häuser, W. (2014). Symptoms, the nature of fibromyalgia, and diagnostic and statistical manual 5 (DSM-5) defined mental illness in patients with rheumatoid arthritis and fibromyalgia. PLoS ONE, 9, e88740. doi: 10.1371/journal.pone.0088740

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This research was financially supported by the Spanish Ministry of Science and Innovation (ref. PSI2009-13765PSIC) and Spanish Ministry of Economy and Competitiveness (ref. PSI2014-58379-P).

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Authors and Affiliations

  1. Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain

    María J. Lami, M. Pilar Martínez, Elena Miró & Ana I. Sánchez

  2. Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain

    M. Pilar Martínez, Elena Miró & Ana I. Sánchez

  3. Department of Nursing, University of Granada, Granada, Spain

    Germán Prados

  4. Rheumatology Service, Virgen de las Nieves University Hospital, Granada, Spain

    Rafael Cáliz

  5. Faculty of Psychology and Educational Sciences, Research Group Health Psychology, University of Leuven, Leuven, Belgium

    Johan W. S. Vlaeyen

  6. Faculty of Psychology and Neuroscience, Research Group Behavioral Medicine, Maastricht University, Maastricht, Netherlands

    Johan W. S. Vlaeyen

  7. Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain

    María J. Lami

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María J. Lami, M. Pilar Martínez, Elena Miró, Ana I. Sánchez, Germán Prados, Rafael Cáliz and Johan W. S. Vlaeyen declares that they have no conflict of interest.

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Lami, M.J., Martínez, M.P., Miró, E. et al. Efficacy of Combined Cognitive-Behavioral Therapy for Insomnia and Pain in Patients with Fibromyalgia: A Randomized Controlled Trial. Cogn Ther Res 42, 63–79 (2018). https://doi.org/10.1007/s10608-017-9875-4

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