Psychoeducation against depression, anxiety, alexithymia and fibromyalgia: a pilot study in primary care for patients on sick leave

Figures & data

Figure 1. Chart showing inclusion/exclusion criteria, completers/non-completers, and respondents/non-respondents to the questionnaires.

Table 1. Prevalence of depression, anxiety, and alexithymia at baseline (T0), within one-week post-intervention (T4), and at 18 months post-intervention (T5).

	Prevalence changes
	Comparisons between T0 and T4 (N = 27)				Comparisons between T0 and T5 (N = 15)
	T0	T4	Prevalence changes	p^a	T0	T5	Prevalence changes	p^a
Depression (HADS-D ≥ 8 p)	16 (59)	7 (26)	−33%	.004	10 (67)	4 (27)	−40%	.031
Anxiety (HADS-A ≥ 8 p)	23 (85)	13 (48)	−37%	.006	12 (80)	9 (60)	−20%	.45
Alexithymia (TAS-20 ≥ 61 p)	9 (33)	3 (11)	−22%	.070	3 (20)	0 (0)	−20%	.25

Data are presented as N (%).

^a McNemar test.

Table 2. Test scores at baseline (T0), within one-week post-intervention (T4), and at 18 months post-intervention (T5).

	Self-report instruments score changes
	Comparisons between T0 and T4 (N = 27)					Comparisons between T0 and T5 (N =15)
	Median (q1, q3)		Median differences (q1, q3)			Median (q1, q3)		Median differences (q1, q3)
	T0	T4	T0–T4	p^a	p^b	T0	T5	T0–T5	p^a	p^b
HADS-D^c	9 (7, 12)	3 (1, 8)	−4 (−7, −2)	<.001	<.004	10 (6, 12)	3 (1, 8)	−5 (−9, −2)	.004	.022
HADS-A^d	12 (8, 15)	7 (5, 11)	−3 (−7, 0)	<.001	<.004	11 (9, 15)	8 (5, 10)	−3 (−5, −1)	.024	.089
TAS-20 total^e	57 (49, 63)	46 (40, 54)	−9 (−16, −3)	<.001	<.004	53 (49, 60)	46 (39, 49)	−7 (−13, −5)	.001	.013
DIF	23 (19, 26)	16 (14, 21)	−6 (−9, −1)	<.001	–	23 (19, 24)	16 (13, 20)	−6 (−8, −2)	.001	–
DDF	14 (10, 18)	11 (10, 14)	−2 (−6, 0)	.009	–	14 (9, 18)	10 (9, 12)	−2 (−7, 1)	.028	–
EOT	21 (16, 23)	18 (15, 22)	−1 (−3, 1)	.11	–	19 (15, 25)	17 (14, 21)	0 (−4, 2)	.25	–
SCI-93^f	45 (36, 60)	30 (23, 40)	−16 (−23, −2)	<.001	<.004	43 (32, 54)	25 (17, 46)	−15 (−24, −8)	.001	.013
EuroQol^g	49 (30, 60)	70 (40, 86)	20 (0, 35)	.001	.004	49 (35, 60)	68 (58, 85)	22 (8, 35)	.002	.013
Self-affirmation	36 (18, 66)	60 (35, 74)	15 (6, 29)	.001	.004	36 (18, 66)	62 (52, 74)	22 (8, 42)	.002	.013
Self-love	44 (22, 58)	56 (35, 74)	12 (2, 27)	.001	.004	44 (26, 68)	66 (55, 76)	22 (9, 34)	.002	.013
Self-protection	45 (30, 66)	60 (40, 71)	3 (0, 18)	.019	.063	54 (29, 69)	69 (49, 74)	8 (3, 24)	.013	.054
Self-blame	45 (20, 58)	30 (14, 42)	−10 (−20, 0)	.004	.015	45 (20, 62)	25 (11, 39)	−12 (−38, 0)	.029	.096
Self-hate	39 (24, 59)	20 (11, 33)	−15 (−24, −2)	.001	.004	38 (18, 59)	17 (8, 23)	− 22 (−38, −4)	.006	.028
Self-neglect	36 (17, 52)	25 (18, 39)	−2 (−14, 2)	.092	.28	35 (14, 58)	19 (8, 28)	−10 (−31, 2)	.034	.10

^a Wilcoxon Signed Ranks Test.

^b The false discovery rate (FDR) control method for multiple analyses.

^c Depression.

^d Anxiety.

^e Alexithymia.

^f MUPS.

^g General Health.

Table 3. Baseline analyses of associations between scores for HADS-D, HADS-A, TAS-20, and for SCI-93 scores for the 36 ASSA starters (T0).

		SCI-93 scores
				Model 1		Model 2
	Median (q1, q3; min-max)	B coefficient	p^a	B coefficient	p^b	B coefficient	p^b
HADS-D scores (depression)	9 (7, 12; 1–19)	2.0	.011	1.6	.032	1.6	.032
HADS-A scores (anxiety)	12 (9, 15; 2–20)	2.3	.004	1.9	.012	1.9	.012
TAS-20 total scores (alexithymia)	56 (49, 62; 31–74)	0.7	.023	0.05	.89	–	–
DIF scores	23 (19, 26; 7–35)	1.2	.065	–	–	0.1	.84
DDF scores	14 (11, 18; 6–22)	0.6	.49	–	–	–	–
EOT scores	20 (16, 23; 10–26)	1.5	.029	–	–	0.6	.35

N = 36.

^a Simple linear regression.

^b Multiple linear regression (Backward).

Detailed protocol for the 8 group-based sessions – the Affect School

Affect theory presented during the 8 Affect School sessions

One hand-out is delivered per session. General affect theory is presented during all sessions. Specific affect theory for each innate affect is presented following the scheme below:

Sessions:

1) Joy

2) Fear

3) Interest and surprise

4) Shame

5) Anger

6) Distaste and dissmell

7) Distress

8) Pain

Script theory presented at all sessions:

1) Affects and experiences together form the individual scripts

2) How we act in different situations and how we interpret experiences are depending on our scripts

3) Scripts are formed by family rules and common cultural rules for how affects should be handled

4) Intensity and expressions of emotion are controlled by scripts

5) Affects can be completely suppressed and thereby unconscious

Coffee break

Affect discussion

Main topics for the affect discussions follow the programme for the eight sessions. Questions used in the affect discussion are:

1) Tell of a situation you felt the affect…

2) How do you know that you feel…?

3) Do you feel … in a particular place in your body?

4) Does it happen often that you feel…?

5) How do you know that someone else is…?

6) Can you understand and accept another person´s…?

7) How does… influence your personal relationships?