DIFFERENTIAL RESPONSES BY PSYCHOSOCIAL SUBGROUPS OF FIBROMYALGIA SYNDROME PATIENTS TO AN INTERDISCIPLINARY TREATMENT

Objectives. To evaluate differential treatment responses among 3 empir ically derived, psychosocial subgroups of patients with fibromyalgia s yndrome to a standard interdisciplinary treatment program. Method. Pat ients were classified into 1 of 3 psychosocial groups on the basis of their responses to the Multidimensional Pain inventory. Forty-eight pa tients completed a 6 one-half-day outpatient treatment program consist ing of medical, physical, occupational, and psychological therapies sp aced over a period of 4 weeks (3 sessions the first week followed by I session per week for the next 3 consecutive weeks). Results. Statisti cally significant reductions were observed in pain, affective distress , perceived disability and perceived interference of pain in the patie nts characterized by poor coping and high level of pain (''dysfunction al'' group). In contrast, individuals who were characterized by interp ersonal difficulties (''interpersonally distressed'' group) exhibited poor responses to the treatment. ''Adaptive copers,'' the third group, revealed significant improvements in pain but due to low pretreatment levels of affective distress and disability showed little improvement on these outcomes. Conclusions. The results provided support for the hypothesis that customizing treatment based on patients' psychosocial needs will lead to enhanced treatment efficacy. They also emphasize th e importance of using appropriate outcome criteria, as low levels of p roblems at baseline are not likely to show significant changes followi ng any treatment.