Pathoplastic Effects of Personality in Fibromyalgia

Abstract

Introduction Fibromyalgia is a disorder characterized by chronic widespread pain and tenderness at palpation of specific points or associated symptoms of fatigue, un-refreshing sleep or cognitive dysfunction. Although his prevalence ranges from 2% to 6,4%, it remains a controversial and an exclusion diagnosis which causes are incompletely understood. Patients have been reported as being perfectionist, introspective, demanding and exhausting to manage. While such personality traits may appear to contribute to fibromyalgia symptoms, the links between them remain unclear. Objectives/Aims The author’s goal is to understand the complex role of personality traits in clinical presentation and management of patients with fibromyalgia. Additionally we present an illustrative clinical case. Methods A literature search was performed using the key words fibromyalgia, personality, trait psychology and retrieved papers were selected according to their relevance. The patient clinical record was reviewed. Results We discuss whether the personality traits result from or cause fibromyalgia symptoms and present a case of a 47 years old woman with fibromyalgia who presents to psychiatrist with a depression syndrome. The personality assessment revealed anxiety, immaturity and impulsivity. A multidisciplinary approach was made with rheumatology, psychiatry and psychology. The patient was treated with antidepressants, mood stabilizers, muscle relaxant and opioid analgesics, as well as psychoeducation. Eighteen months later, the patient remains with pain and concentration complaints, having improved sleep and functional capacity. Conclusions Personality might be involved in various aspects of chronic pain, as seen in fibromyalgia, and be involved in triggering, maintaining and exacerbation of the fibromyalgia’s process.