Psychodynamic Interventions for Fibromyalgia: A Systematic Review.
Clin Neuropsychiatry 2026 Jun; 23(3):255-265.

Abstract

Objective

fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, sleep disturbances, and psychological distress, with a significant impact on quality of life. While cognitive-behavioral therapy has been extensively studied as a psychological intervention for FM, the effectiveness of psychodynamic interventions remains underexplored. This systematic review aims to synthesize the existing literature on psychodynamic interventions for FM, focusing on their impact on clinical and psychological outcomes.

Method

a systematic search was conducted across PsycINFO, Cochrane, PubMed, and Web of Science databases. A total of six studies meeting the inclusion criteria were identified, investigating different psychodynamic approaches, including Attachment-Based Compassion Therapy, Emotional Awareness and Expression Therapy, and shortterm psychodynamic psychotherapy.

Results

across these studies, psychodynamic interventions showed potential - but still preliminary - benefits, including reductions in pain severity, anxiety, depression, and psychological distress, alongside improvements in emotional functioning and quality of life. However, substantial heterogeneity across interventions, study designs, and outcome measures, combined with moderate-to-high risk of bias and the small number of available studies, limits the strength of the conclusions.

Conclusions

the current evidence does not allow definitive recommendations regarding psychodynamic interventions for FM. Further methodologically rigorous research is needed to clarify the specific efficacy, generalizability, and underlying mechanisms of these interventions.

Links

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Authors+Show Affiliations

Alessandro TDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Martina MDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Marco CDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Sara BDepartment of Brain and Behavioral Sciences, University of Pavia, Italy. Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation, Pavia, Italy.
Lorys CDepartment of Psychology, University of Turin, Italy.
Filippo MNDepartment of Theoretical and Applied Sciences (DiSTA), eCampus University.
Martina CDepartment of Brain and Behavioral Sciences, University of Pavia, Italy.
Agata BDepartment of Psychology, University of Turin, Italy.
Annunziata RDepartment of Psychology, University of Turin, Italy.
Alessia RDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Annalisa TDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Rachele MDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Chiara PDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Michela DTDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.
Piercarlo SPRheumatology Department, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy. Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy.
Carmen MGDepartment of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain.
Federica GDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University ofRome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

42383142