Efficacy of hypnosis/guided imagery in fibromyalgia syndrome - a systematic review and meta-analysis of controlled trials
1 Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital, Kirrberger Straße 100, D-66421 Homburg/Saar, Germany
2 Department of Differential Psychology and Psychodiagnostics, Saarland University, Im Stadwald, D-66123 Saarbrücken, Germany
3 Department of Internal Medicine V (Integrative Medicine), University of Duisburg-Essen, Kliniken Essen-Mitte, Am Deimelsberg 34a, D-45276 Essen, Germany
4 Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany
5 Department of Psychosomatic Medicine, Technische Universität München, Ismaninger Straße 22, D-81675 München, Germany
BMC Musculoskeletal Disorders 2011, 12:133 doi:10.1186/1471-2474-12-133Published: 15 June 2011
Recent systematic reviews on psychological therapies of fibromyalgia syndrome (FMS) did not consider hypnosis/guided imagery (H/GI). Therefore we performed a systematic review with meta-analysis of the efficacy of H/GI in FMS.
We screened http://ClinicalTrials.gov webcite, Cochrane Library, MEDLINE, PsycINFO and SCOPUS (through December 2010). (Quasi-) randomized controlled trials (CTs) comparing H/GI with controls were analyzed. Outcomes were pain, sleep, fatigue, depressed mood and health-related quality of life (HRQOL). Effects were summarized using standardized mean differences (SMD).
Six CTs with 239 subjects with a median of 9 (range 7-12) H/GI-sessions were analysed. The median number of patients in the H/GI groups was 20 (range 8-26). Three studies performed follow-ups. H/GI reduced pain compared to controls at final treatment (SMD -1.17 [95% CI -2.21, -0.13]; p = 0.03). H/GI did not reduce limitations of HRQOL at final treatment (SMD -0.90 [95% CI -2.55, 0.76]; p = 0.29) compared to controls. Effect sizes on fatigue, sleep and depressed mood at final treatment and follow-up and on pain and HRQOL at follow-up were not calculated because of limited data available. The significant effect on pain at final treatment was associated with low methodological and low treatment quality.
Further studies with better treatment quality and adequate methodological quality assessing all key domains of FMS are necessary to clarify the efficacy of H/GI in FMS.