Brief psychodynamic therapy for depressive symptoms in fibromyalgia: preliminary findings from a multicentre randomised trial

Background. Fibromyalgia (FM) and related chronic pain conditions frequently involve elevated psychological distress, especially depression. While brief psychological interventions are increasingly adopted in pain care, comparative evidence remains limited. Brief Psychodynamic Therapy (BPT), focused on interpersonal patterns and emotional regulation, may offer specific benefits for these patients. Objective. This study examined the preliminary short-term efficacy of Brief Psychodynamic Therapy (BPT), compared with Expressive Writing Technique (EWT) and Treatment as Usual (TAU), across FM, CM, and FibroMig, with a particular focus on depressive symptoms. Methods. A multicentre randomised controlled trial including women aged 18–65 allocated participants to BPT, EWT, or TAU. Outcomes were assessed at baseline (T0) and post-treatment (T1). Measures included VASPain, CSI, SF-12, MPQ, GAD-7, and PHQ-9. Three-way repeated-measures ANOVAs tested effects of time, diagnosis, and treatment. Results. The sample included 101 participants (42 FM, 35 CM, 24 FibroMig). Diagnostic groups differed at baseline in CSI and physical functioning. No treatment × time interaction emerged for pain, central sensitisation, anxiety, mental pain, or HRQoL. However, a significant treatment effect and time × treatment interaction were found for PHQ-9, indicating that only BPT produced a clinically meaningful reduction in depressive symptoms from T0 to T1, regardless of diagnosis. EWT and TAU showed no improvement. Conclusion. Preliminary findings suggest that BPT may serve as an effective transdiagnostic intervention for depressive symptoms in chronic pain, including FM, CM, and FibroMig. Its feasibility and selective impact support its integration within multidisciplinary pain management pathways.