Neuroticism and Fibromyalgia Syndrome: A Systematic Review and Meta-analysis

Abstract

Context: Neuroticism is associated with a heightened experience of bodily sensations and pain. This suggests that psychosocial factors can affect biological mechanisms. However, it is unclear whether fibromyalgia (FM) is associated with neuroticism and how these factors may be related. Objectives: This study attempted to incorporate recent studies on fibromyalgia and neuroticism to comprehensively explain it. Methods: In this systematic review and meta-analysis based on the PRISMA guidelines (2020), PubMed, Psych INFO, Social Sciences, Scopus, ProQuest, and Google Scholar were searched for quantitative studies published up to August 31, 2022. Results: Nineteen cross-sectional studies met the meta-analytic inclusion criteria, totaling 7,881 participants. The meta-analysis demonstrated high levels of neuroticism in fibromyalgia patients compared with control groups (Hedges’ g = 0.78; 95% CI = 0.54 − 1.02; P < 0.001). This meta-analysis provides evidence of the role of neuroticism as a contributing factor in the development and manifestation of fibromyalgia. Meta-regression and subgroup analyses were also conducted to investigate the potential moderators that might have influenced the effect size. The results of the meta-regression and subgroup analyses revealed that the health condition of the control group and the sex of the participants were significant moderators affecting the effect size. Conclusions: The results suggest that neuroticism should be specifically assessed and targeted in fibromyalgia interventions, especially in women. Furthermore, there should be particular emphasis on the mechanisms through which neuroticism may contribute to an increased risk of persistent pain and somatic complaints. As a result, fibromyalgia patients with high neuroticism levels should receive multimodal interventions to address neuroticism.