Brief Psychodynamic Therapy was compared to Cognitive Therapy.

Both psychotherapies seem to be effective in reducing anxiety and pain intensity.

Attachment and alexithymia were significant predictors of pain intensity.

Only alexithymia predicted psychological distress.

The present study mainly aimed to assess the effectiveness of Brief Psychodynamic Therapy (BPT) with respect to Cognitive-Behavioural Therapy (CBT) for the treatment of patients with Fibromyalgia (FM). As a secondary goal, we evaluated whether individual characteristics (attachment dimensions and alexithymia) contributed to predict treatment outcomes (anxiety and depression symptoms, and pain intensity).

A pilot randomised trial was conducted, with two repeated measures (at baseline - T0, and after the intervention - T1). Sixty-one female patients with FM were randomly allocated to the BPT group or CBT group and filled out the following questionnaires pre- and post-treatment: the Hospital Anxiety and Depression Scale (HADS), Fibromyalgia Impact Questionnaire (FIQ-R) Pain, Toronto Alexithymia Scale (TAS-20), and Relationship Questionnaire (RQ).

Results of mixed-design ANOVAs revealed that there was an effect of time on both anxiety and pain symptoms scores, with a decrease in these symptoms from T0 to T1. Conversely, no group effect or time by group interaction was found. Multiple regression analyses showed that both the RQ “Dismissing” and TAS-20 total score were significant predictors of pain intensity after treatment. The TAS-20 total score was found to be the only predictor of HADS-Anxiety and HADS-Depression scores post-treatment.

The present findings have shown that both psychotherapies seem to be equally effective in reducing anxiety symptoms and pain intensity in FM. Furthermore, both attachment and alexithymia were found to be significant predictors of pain intensity, whereas only alexithymia predicted anxiety and depression symptoms in the aftermath of treatment.

Fibromyalgia

Chronic pain

Anxiety

Depression

Brief psychotherapy

© 2025 The Authors. Published by Elsevier Ltd.