Effect of Cognitive-Behavioral Therapy ‎on the Oxidative Balance of Fibromyalgia ‎Patients: A Randomized Controlled Trial

Background: Cognitive-behavioral therapy (CBT) is acknowledged as an efficient therapeutic modality in fibromyalgia. However, its effect on the oxidative balance of fibromyalgia patients has not been investigated. Objectives: We investigated whether CBT intervention could influence serum markers of oxidative balance. Methods: Forty fibromyalgia patients were randomly assigned to either the intervention (CBT) or control (waiting list) group. For the intervention group, traditional face-to-face CBT was performed for 20 sessions over two months. Sixteen patients in the CBT group and 17 patients in the control group completed the study. Outcomes were the serum total oxidant status (TOS) and total antioxidant capacity (TAC) that were assessed before the intervention and at the end of the intervention by an oxidation-reduction colorimetric assay. Within-group and between-group analyses were performed using the Wilcoxon signed-rank test and Mann–Whitney U test, respectively. Results: Baseline characteristics showed no significant difference between the participants of the two groups. At the end of the study, mean TOS significantly reduced in the case group (P < 0.001) but not in the control group (P = 0.61), and mean TAC showed no significant change in the case and control groups (P = 0.1 and P = 0.09, respectively). The mean change in TOS was 0.43 ± 0.3 mM in the CBT group and 0.03 ± 0.2 mM in the control group (P < 0.001). The mean change in TAC was 0.015 ± 0.03 mM in the CBT group and 0.01 ± 0.02 mM in the control group (P = 0.57). Conclusions: Cognitive-behavioral therapy improves the oxidative balance of fibromyalgia patients. Our results further support the benefits of CBT implication in the treatment of fibromyalgia.