Impact Of Fibromyalgia Syndrome Research Articles

Fibromyalgia syndrome in mothers of children with cerebral palsy and its relationship with caregiver burden: a cross-sectional study

Objectives: Fibromyalgia syndrome (FMS) is a stress-related disease. The birth of a child with cerebral palsy (CP) is an important stress factor for the mother. This study aims to investigate the incidence of FMS in mothers of children with CP by comparing it with the control group and determining the factors affecting the severity of FMS. Methods: The study included 112 children with CP (age: 38-216 months), their caregiver mother (age: 23-50 years) (Group 1) and 52 non-disabled children (age: 40-180 months), their caregiver mothers (age: 27-50 years) (Group 2). Children were evaluated with the Gross Motor Function Classification System (GMFCS) and the functional independence scale for children (WeeFIM). The mothers were evaluated according to the 2010 ACR FMS diagnostic criteria. The FMS Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), and the Bakas Caregiving Outcomes Scale (BCOS) were applied. Results: In Group 1, mothers had higher anxiety-depression scores and caregiving burden than Group 2 (p < 0.05). FMS rate was %31.3 in Group 1 and %5.7 in Group 2. Mothers' anxiety-depression scores, widespread pain index, symptom severity score, pain, and caregiver burden were higher in Group 1 than in Group 2 (p < 0.05). Factors affecting the severity of FMS are the number of siblings of children with CP, the number of siblings with CP, GMFCS, dependence level, anxiety-depression levels of mothers, and caregiver burden. The most influential factor is the caregiver burden. Conclusions: Long-term heavy caregiver burden in mothers of children with CP may be effective in developing FMS.

Effect of prebiotic and probiotic supplementation on reduced pain in patients with fibromyalgia syndrome: a double-blind, placebo-controlled randomized clinical trial

ABSTRACT It has recently been observed that microorganisms in the gut can regulate brain processes through the gut microbiota-brain axis, affecting pain, depression, and sleep quality. Consequently, prebiotics and probiotics may potentially improve physical, psychological, and cognitive states in those with fibromyalgia syndrome (FMS) who have an altered microbiota balance. In a randomised, double-blind, placebo-controlled clinical trial to determine the effects of probiotic and prebiotic treatments on pain, sleep, quality of life, and psychological distress (depression and anxiety) in FMS, 53 female participants with FMS were randomised to receive either: 1) 4 × 1010 CFUs per day for the 18 patients in the probiotics group; 2) 10 g dose inulin per day for the 17 patients in the prebiotic group; or 3) a placebo for 8 weeks for the 18 patients in this group. The mean ages of the groups were similar and there was no significant difference between the groups. The impact of FMS on pain, sleep quality, quality of life, anxiety, and depressive symptoms were measured at baseline, 4 weeks, and 8 weeks post-intervention. Probiotic supplementation significantly decreased the Beck Depression Index (BDI), Beck Anxiety Index (BAI), and Pittsburgh Sleep Quality Index (PSQI) scores compared to baseline, while prebiotic supplementation only significantly decreased PSQI scores. Moreover, participants who received probiotic treatment presented a significantly reduced Visual Analogue Scale (VAS) score compared with those who received placebo treatment, after the interventions. Probiotic supplementation significantly improved sleep quality, depression, anxiety, and pain scores compared to those at baseline in FMS patients, while prebiotic supplementation significantly improved pain scores and sleep quality. The potential benefits of using probiotics for treatment management in FMS patients is supported by the results of the current study and might provide an important strategy to combat FMS-associated diseases.

The impact of fibromyalgia syndrome on obstructive sleep apnea syndrome in terms of pain threshold, daytime symptoms, anxiety, depression, disease severity, and sleep quality: a polysomnographic study.

Current studies have focused on the association of fibromyalgia syndrome (FMS) and obsctructive sleep apnea syndrome (OSAS). Results of these studies on the effect of this association have been inconsistent. The current study aimed to investigate the effect of FMS on OSAS regarding sleep quality, pressure pain threshold, fatigue, daytime symptoms, anxiety, and depression, and also to determine the relationship between OSAS severity and FMS. In a cross-sectional design, patients diagnosed with OSAS were evaluated in two groups comparing those with and those without FMS. Data on demographics, headache, morning fatigue, and chronic pain duration were collected. Questionnaires including the Fatigue Severity Scale (FSS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were completed. Pressure pain threshold, tender points, and polysomnographic data were recorded. Of 69 patients, 27 were diagnosed with FMS + OSAS and 42 were diagnosed as OSAS only. Statistically significant differences were found between the two groups in VAS, pain duration, morning fatigue, headache, BAI, tender point count, FIQ and FSS scores, and algometer measurements. All polysomnografic data were compared, and no statistically significant differences were found between the two groups. There were no statistically significant differences in the algometer, BDI, BAI, FIQ, and FSS scores when analyzed according to the severity of OSAS. The findings suggest that FMS has no effect on polysomnographic parameters of OSAS. Headache, daytime fatigue, anxiety, depression, pain duration, and pain intensity are higher while the pressure pain threshold is lower when FMS is present. No correlation was found between OSAS severity and FMS, fatigue, pressure pain threshold, depression, and anxiety. NCT05367167/date: April 8, 2022.

The vicious cycle of physical inactivity, fatigue and kinesiophobia in patients with fibromyalgia syndrome.

This study aims to determine the association between fatigue, kinesiophobia, disease severity, and physical inactivity by comparing fibromyalgia syndrome (FMS) patients with healthy controls. Pain and fatigue are significant barriers to the participation in functional activities. Inactivity is a result of fatigue, but exercise is the foundation of FMS treatment. This case-control study included a total of 203 participants (107 patients with FMS and 96 healthy volunteers). The fibromyalgia impact questionnaire, the fatigue severity scale, the international physical activity questionnaire, and the Tampa scale for kinesiophobia were assessed. The FMS group scored significantly higher on the fatigue severity scale and kinesiophobia than the control group (p<0.001). Significantly lower metabolic task equivalent (MET) scale values were observed in the FMS group compared to the control group (p<0.001). The severity of fatigue and kinesiophobia correlated positively with the FMS impact questionnaire (p=0.001, r=0.621) and negatively with the MET scale (p=0.009, r= -0.287). Patients with FMS experience greater fatigue, kinesiophobia, and inactivity. As the severity of FMS worsens, so do disability, kinesiophobia, and fatigue. This study highlights the importance of breaking the cycle of fatigue and inactivity in the treatment of FMS.

Physical activity and quality of life of patients with fibromyalgia.

Fibromyalgia Syndrome (FMS) has been linked to decreased social functioning, poor mental health, and quality of life (QOL). Increased physical functioning and activity can result in improvements in social, mental and overall health, as well as lowered depression and anxiety levels. The aim of this study was to determine physical activity levels and QOL amongst patients diagnosed with fibromyalgia in the Johannesburg region of South Africa. The research design was cross-sectional. Descriptive and quantitative data were collected. FMS patients (n=38) completed an online questionnaire on the Google Forms platform. The questionnaire was comprised of four components, namely Demographics, the Global Physical Activity Questionnaire (GPAQ), the Fibromyalgia Impact Questionnaire (FIQR), and the Short Form-36 (SF-36). During data analysis, descriptive characteristics and correlations were computed. The significance level was set at p ≤ 0.05. Results revealed high FIQR scores (67%) accompanied with low QOL scores (<50% in all domains). There was no correlation between physical activity and FIQR, and physical activity and QOL. High scores on the impact of FMS were associated with lower overall QOL scores. However, the relationship between physical activity, and the impact of FMS and QOL remain inconclusive.

The frequency of fibromyalgia in familial Mediterranean fever and its impact on the quality of life.

Concomitant fibromyalgia syndrome (FMS) has been known to be more frequent in patients with several rheumatic diseases. In this study, our aim was to investigate the prevalence of FMS in patients with familial Mediterranean fever (FMF), to analyze the possible factors related to this frequency, and to evaluate the impact of FMS on the functionality and quality of life (QoL) of the patients with FMF. One hundred cases with FMF and 100 controls were included to this case-control study. FMS coincidence was investigated in all participants according to revised 2016 classification criteria. Demographic features, FMF disease duration, FMF gene mutations, drugs used, attack frequency per year, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum fibrinogen levels were recorded. FMF disease severity was assessed by International Severity Scoring System for Familial Mediterranean Fever (ISSF). For the assessments of QoL and functioning, FMF-QoL, Short form 36 (SF-36), and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used, and for the assessment of FMS impact, the fibromyalgia impact questionnaire (FIQ) were used. We found an FMS frequency of 33% in patients with FMF in our study using the current FMS classification criteria. This result was significantly higher than in age- and gender-similar controls (6% FMS frequency; P < 0.05). The number of woman patients and FMF disease duration were significantly higher in patients with FMF + FMS than in patients with only FMF (P < 0.001). There was no significant difference in ISSF scores, ESR, CRP, and fibrinogen levels, management regimens, and FMF gene mutation distributions between FMF + FMS and FMF groups. FMF attack frequency was reported as significantly higher in FMF + FMS patients than in others (P < 0.000). In spite of similar FMF-QoL scores, there were significant differences in HAQ-DI and SF-36 scores between groups (P < 0.05). Higher impact of FMS presented negative correlation with functioning and general health, and positive correlation with QoL in FMF + FMS (P < 0.05). Concomitant FMS was a common clinical problem in patients with FMF regardless of the severity and characteristics of FMF. The FMS impact may affect function and QoL in patients of FMF. Considerations of the FMS component in the management of FMF may contribute to the holistic approach to FMF.

Impact of Fibromyalgia Syndrome on the Severity of Migraine Without Aura

Background: Migraine is a common neurological disorder associated with periodical disability and impaired quality of life. Recent large epidemiological studies have shown high levels of concurrency between fibromyalgia syndrome (FMS) and migraine. Objectives: Due to the possible relationship between migraine and FMS, we aimed to measure the effect of FMS on the severity of migraine without aura (MWO). Methods: This is a cross-sectional study of 80 patients with MWO who were referred to Isfahan Al-Zahra Clinic of Neurology. To monitor the patients, the researcher asked them to complete the demographic data and questionnaires, including FSQ-P for diagnosis FMS, HIT-6 for the severity of migraine headache, and MSQ for measuring the quality of life, with their written consent. Results: Of 80 patients with MWO, 22.5% suffered from FMS. Based on our study, elderly patients with MWO were more likely to be affected by FMS. Additionally, the average quality of life score in the migraineurs with FMS was significantly lower than the migraineurs without FMS. According to our findings, the severity of migraine was not significantly different between patients with and without FMS. In addition, age (OR = 1.1, 95% CI = 1.006-1.2, P &lt; 0.001] and quality of life (OR = 1.03, 95% CI = 1.002 - 1.07, P = 0.04) were the predictive factors for FMS in patients suffering from migraine. Conclusions: The findings of this study may support that the presence of FMS had no effect on the severity of migraine; however, further studies are needed to clarify this claim.

Symptomatology of Fibromyalgia Syndrome in Men: A Mixed-Method Pilot Study.

Fibromyalgia syndrome (FMS) is characterized by generalized chronic musculoskeletal pain, fatigue, and sleep disturbance, as well as cognitive, somatic, and other symptoms. Most people affected by FMS are women, and studies analyzing this condition in men are scarce. In this study, we discuss the physical and psychological symptoms of FMS in men, analyze the possible side effects of pharmacological therapies, and explore the impact of the illness comparing these results between the different classification groups according to sociodemographic variables (marital status, level of education, employment situation and number of people living at home). We used a sequential exploratory mixed method (MM). Qualitative information was obtained from two focus groups (n = 10). Structured questionnaires were administered to 23 men affected by FMS. The mean age of the participants was 51.7 years (SD = 9.64). The most common drugs used were antidepressants and anxiolytics (86.9%), followed by non-steroidal anti-inflammatory drugs (82.6%) and opioids (60.9%). Current level of pain was high (8.2; SD = 1.1), while perceived health and satisfaction with pharmacological treatments were low (4.6; SD = 2.6 and 3.5; SD = 3.2, respectively). The impact of FMS measured using the Fibromyalgia Impact Questionnaire (FIQ) was very high at 88.7 (SD = 8.2). Six categories related with symptoms and side effects of the medication were observed in the qualitative data: (1) main physical symptoms, (2) mood disorders, (3) insomnia and non-restorative sleep, (4) cognitive disturbance, (5) hypersensitivity, and (6) symptoms secondary to opioids. Pain and fatigue were the symptoms most often mentioned by the participants (70% and 80%, respectively). Other important symptoms were anxiety, depression, and memory and sleep disorders. The consumption of opioids causes further unwanted symptoms such as drowsiness and dependence, which makes it difficult for patients to perform basic everyday activities. We believe it is vitally important to continue investigating this symptomatology in order to improve diagnosis and treatment for these patients.

Health-Related Quality of Life and Related Factors in Patients with Fibromyalgia: A Cross-sectional Study

Background: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition, which can reduce the quality of life (QoL). Objectives: This study aimed to evaluate the impact of FMS on health-related quality of life (HRQoL) and the possible related factors such as sociodemographic and psychological variables. Methods: In this cross-sectional study, 150 women patients with FMS were included who visited a psychosomatic clinic at a referral center in northern Iran. The samples were selected in a consecutive procedure from April 2019 to March 2019. Sociodemographic variables, HRQoL score [36-Item Short Form (SF-36) Health Survey], and the Pittsburgh Sleep Quality Index (PSQI) were recorded. Data were analyzed using the SPSS Statistics software (ver. 24). The quantitative data were reported as mean ± SD, and the qualitative variables were presented as frequency and percentage. Also, analysis was performed using analytical tests such as chi-square test (χ2). P &lt; 0.05 was considered to be significant. Results: The mean (SD) age was 42.35 (11.73) years. The mean physical and mental health scores were 33.45 (16.22) and 48.99 (18.19), respectively. Moreover, 88% of patients had moderate-to-severe sleep disorder, and those who did not, had a better physical and mental health status [42.7 (14.1) vs. 32.2 (16.1), P-value = 0.009 and 62.2 (16.3) vs. 47.2 (17.7), P-value = 0.001, respectively]. History of depression according to self-reporting was associated with worse mental health subscale scores [44.4 (16.8 Vs. 52.4 (18.5), P-value = 0.007], and lower scores in social functioning and emotional well-being (P-value = 0.012, P-value = 0.001, respectively). Being postmenopausal was associated with a lower physical health quality (P-value = 0.049). Body Mass Index (BMI) reversely correlated with HRQoL subscales (r = -0.163, P-value = 0.046), but the subscales were not affected by the level of income (P-value = 0.644, P-value = 0.170, respectively). Conclusions: Patients with fibromyalgia report a considerable significant impact on their quality of life and impaired sleep quality. Assessment of sleep quality and QoL are needed in patients with fibromyalgia.

Does fibromyalgia affect physical activity due to pain?

The aim of this case-control study was to evaluate the physical activity levels of patients with fibromyalgia syndrome (FMS) and to assess a possible relation between physical activity and FMS characteristics. Seventy patients with FMS and 50 age-gender-matched controls were included. Pain was evaluated using the visual analog scale. The Fibromyalgia Impact Questionnaire (FIQ) scoring system was used for the evaluation of the impact of FMS. Furthermore, for assessing the physical activity in our participants, we used the International Physical Activity Questionnaire (IPAQ). The Mann-Whitney U and Pearson's correlation tests were used for group comparisons and correlation analyses. The patients presented significantly less transportation-related, recreational, and total physical activity levels, besides reporting significantly less time spent walking and less time spent in vigorous activities than controls (p<0.05). Furthermore, there was a negative correlation between pain and the scores of self-reported moderate or vigorous physical activity (r=-0.41, p<0.01) in patients. However, we could not find any correlation between FIQ and IPAQ scores. Patients with FMS are physically less active than healthy individuals. This reduced activity seems to be associated with pain, but not with the impact of the disease. In the management of the patient with FMS, considering the patient's physical activity behavior negatively affected by pain may contribute to holistic approach to the patients.

Virtual Reality-Based Therapy Reduces the Disabling Impact of Fibromyalgia Syndrome in Women: Systematic Review with Meta-Analysis of Randomized Controlled Trials.

Background: Virtual reality-based therapy (VRBT) is a novel therapeutic approach to be used in women with fibromyalgia syndrome (FMS). The aim of our study is to assess the effect of VRBT to reduce the impact of FMS in outcomes such as pain, dynamic balance, aerobic capacity, fatigue, quality of life (QoL), anxiety and depression. Methods: Systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science and CINAHL until April 2021 in accordance with PRISMA guidelines. We included randomized controlled trials (RCTs) that compare VRBT versus others to assess the mentioned outcomes in women with FMS. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). Results: Eleven RCTs involving 535 women with FMS were included. Using the PEDro scale, the mean methodological quality of the included studies was moderate (6.63 ± 0.51). Our findings showed an effect of VRBT on the impact of FMS (SMD −0.62, 95% CI −0.93 to −0.31); pain (SMD −0.45, 95% CI −0.69 to −0.21); dynamic balance (SMD −0.76, 95% CI −1.12 to −0.39); aerobic capacity (SMD 0.32, 95% CI 0.004 to 0.63); fatigue (SMD −0.58, 95% CI −1.02 to −0.14); QoL (SMD 0.55, 95% CI 0.3 to 0.81); anxiety (SMD −0.47, 95% CI −0.91 to −0.03) and depression (SMD −0.46, 95% CI −0.76 to −0.16). Conclusions: VRBT is an effective therapy that reduces the impact of FMS, pain, fatigue, anxiety and depression and increases dynamic balance, aerobic capacity and quality of life in women with FMS. In addition, VRBT in combination with CTBTE showed a large effect in reducing the impact of FMS and fatigue and increasing QoL in these women.

Fibromyalgia influences health-related quality of life and disease activity in psoriatic arthritis.

Fibromyalgia syndrome (FMS) is common in patients of psoriatic arthritis (PsA), but the magnitude of its impact is uncertain. Thiscross-sectional study evaluated the impact of FMS on health-related quality of life (HRQoL) and disease activity in PsA. Adults classified with PsA (CASPAR criteria) at the rheumatology and dermatology outpatient clinics of PGIMER, Chandigarh, India between January 2014 and June 2015were recruited. All patients were assessed for FMS using the 2010 ACR criteria. Health-related quality of life was assessed using PROMIS-HAQ, HAQ-pain, HAQ-health and revised fibromyalgia impact questionnaire (FIQR). Disease activity measures (SJC, TJC, BASDAI, enthesitis, dactylitis, PASI) and PROMIS-HAQ were correlated with measures of FMS [FIQR, symptom severity scale (SSS) score and widespread pain index (WPI)]. Multivariate regression analyses were used to identify predictors of PROMIS-HAQ and FMS. Out of 106 PsA patients screened, 102 [50 (49%) females; mean age 43.8 (12.4) years] were included. 19 (18.3%) had FMS. Patients of PsA with FMS had significantly (p < 0.05) higher TJC (14vs7), SJC (10vs5), BASDAI (6.1vs4.1) and enthesitis (53 vs 33%), but no difference in dactylitis, severity of skin disease and disease duration. A significant positive correlation of measures of FMS (FIQR, SSS and WPI) with SJC, TJC and BASDAI was noted. PROMIS-HAQ, HAQ-pain and HAQ-health were significantly worse (p < 0.001) in patients of PsA with coexisting FMS. Presence of FMS was found to be an independent predictor of worse PROMIS-HAQ. Female gender and higher TJC independently predicted presence of FMS.To conclude, FMS is an important contributor towards poor HRQoL in patients of PsA and is associated with higher values of joint disease activity measures.

The relationship between vitamin 25(OH)D level and hematological parameters in newly diagnosed women with fibromyalgia syndrome

Background/Aim: Chronic inflammation may play a role in the pathogenesis of fibromyalgia syndrome (FMS). Several hematological markers are prothrombotic, and markers of systemic inflammation. Vitamin D (VitD) level can affect FMS and has an anti-inflammatory effect. The aim of this study is to investigate the relationship between hematological parameters and VitD in FMS and its effect on disease severity. Methods: The prospective case-control study included 90 newly diagnosed female patients with FMS (group 1) and 90 healthy volunteers (group 2). Pain and fatigue were evaluated by visual analogue scale (VAS). Disease severity was evaluated by FMS Impact Questionnaire (FIQ) in FMS. Neutrophils, lymphocytes, platelets, platelet distribution width (PDW) and mean platelet volume (MPV) were obtained from complete blood count results in both groups. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were calculated. 25(OH)D concentration was measured. Patients were divided into 3 groups according to vitamin D levels (VitD 30 ng/ml.) Results: The mean MPV and vitamin D levels were significantly higher in group 2 (P=0.001, P 0.05). There was a significant inverse relationship between FIQ and PLR (P=0.022). Conclusion: VitD deficiency may be a risk factor for FMS (cut-off is<14.6 ng/ml). In FMS, high PDW and high PLR in patients with VitD<10 ng/ml are indicative of a prothrombotic condition which can be aggravated by inflammation. We think that complete blood count and VitD levels can support the diagnosis and predict cardiovascular risk in FMS.

Preferred exercise and mental health of the patients with fibromyalgia syndrome

Background and purposePreferred exercise may be beneficial for the mental health of patients with fibromyalgia syndrome (FMS).This study aimed to investigate the effects of preferred exercise on the quality of life (Qol), depression, and mood states of the patients with FMS. Materials and methodsThis study was a nonrandomized controlled trial. The patients with FMS were divided into an experimental group (EG; n = 22) and a control group (CG; n = 14). The patients in the EG performed their preferred exercise (resistance, walking, or stretching) for 12 weeks. CG went to a waiting list. Fibromyalgia Impact Questionnaire, Beck Depression Inventory, and Brunel Mood Scale were used to evaluate the outcomes. ResultsThe EG exhibited a decrease in the total impact of FMS on the Qol, depression, tension, and mental confusion (p < 0.01). ConclusionPreferred exercises reduced the impact of FMS on the Qol, depression, and mental confusion of patients with FMS.

Psychological impact of fibromyalgia: current perspectives.

Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread and persistent musculoskeletal pain and other frequent symptoms such as fatigue, insomnia, morning stiffness, cognitive impairment, depression, and anxiety. FMS is also accompanied by different comorbidities like irritable bowel syndrome and chronic fatigue syndrome. Although some factors like negative events, stressful environments, or physical/emotional traumas may act as predisposing conditions, the etiology of FMS remains unknown. There is evidence of a high prevalence of psychiatric comorbidities in FMS (especially depression, anxiety, borderline personality, obsessive-compulsive personality, and post-traumatic stress disorder), which are associated with a worse clinical profile. There is also evidence of high levels of negative affect, neuroticism, perfectionism, stress, anger, and alexithymia in FMS patients. High harm avoidance together with high self-transcendence, low cooperativeness, and low self-directedness have been reported as temperament and character features in FMS patients, respectively. Additionally, FMS patients tend to have a negative self-image and body image perception, as well as low self-esteem and perceived self-efficacy. FMS reduces functioning in physical, psychological, and social spheres, and also has a negative impact on cognitive performance, personal relationships (including sexuality and parenting), work, and activities of daily life. In some cases, FMS patients show suicidal ideation, suicide attempts, and consummated suicide. FMS patients perceive the illness as a stigmatized and invisible disorder, and this negative perception hinders their ability to adapt to the disease. Psychological interventions may constitute a beneficial complement to pharmacological treatments in order to improve clinical symptoms and reduce the impact of FMS on health-related quality of life.

The impact of fibromyalgia syndrome and the role of comorbidity with mood and post-traumatic stress disorder in worsening the quality of life

The aim is to measure the association between fibromyalgia syndrome (FMS) and post-traumatic stress disorder (PTSD), mood and anxiety disorders using reliable psychiatric diagnoses according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) and with a case-control design. Case-control study with cases (71 consecutive female patients with FMS) and controls (284 subjects without FMS), randomly drawn after a gender- and age-matching technique from the database of an epidemiological survey. Psychiatric diagnoses were conducted according to DSM-IV and carried out by clinical staff using a structured interview (Advanced Neuropsychiatric Tools and Assessment Schedule). QoL was measured by Short Form Health Survey (SF-12). The lifetime prevalence of major depressive disorder (MDD; 43.7% vs 8.1%, p < .0001), bipolar disorder (BD; 21.1% vs 0.7%, p < .0001), PTSD (8.4% vs 1.4%, p < .0001) and panic disorder (28.2% vs 5.6%, p < .001) was higher in people with FMS than in controls. People with FMS showed a poorer QoL than controls on the SF-12 (26.43 ± 6.04 vs 37.45 ± 5.80, p < .0001). Those with comorbidity with MDD and BD showed a mean SF-12 score of 24.75 ± 6.31 versus 29.52 ± 4.84 ( N = 25) of people with FMS without any mood disorder ( p = .002). The attributable burden of FMS in worsening QoL was found comparable to that of serious chronic diseases such as multiple sclerosis. FMS is a disorder that 'in itself' can have a devastating impact on an individual's life. The frequency of the association with major depressive and bipolar disorders increases the impact on the QoL of people with FMS. One of the causes of this association appears to be the extreme vulnerability to chronic stress that this disorder involves. The findings have important clinical significance: the physician must interpret in the right dimension and with dignity the suffering of the people with FMS.

'Exercise to me is a scary word': perceptions of fatigue, sleep dysfunction, and exercise in people with fibromyalgia syndrome-a focus group study.

Fibromyalgia syndrome (FMS) is a common and complex chronic pain condition. Exercise is recommended in the management of the FMS; however, people with FMS often find exercise exacerbates their condition and causes overwhelming fatigue. The objective of this study was to explore the perceptions of fatigue and sleep dysfunction, and exercise in people with FMS. Three, 60-90min focus groups were conducted with people with FMS (n = 14). Participants were recruited from patient support groups who had experienced therapeutic exercise in the management of their condition. Focus groups were video and audio recorded and transcriptions analysed for thematic content by three independent evaluators. Fatigue, sleep dysfunction, and pain were universally reported by participants. The over-arching theme to emerge was a lack of understanding of the condition by others. A huge sense of loss was a major sub-theme and participants felt that they had fundamentally changed since the onset of FMS. Participants reported that they were unable to carry out their normal activities, including physical activity and exercise. The invisibility of FMS was associated with the lack of understanding by others, the sense of loss, and the impact of FMS. People with FMS perceive that there is a lack of understanding of the condition among health care professionals and the wider society. Those with FMS expressed a profound sense of loss of their former 'self'; part of this loss was the ability to engage in normal physical activity and exercise.

Screening for Adult ADHD in Patients with Fibromyalgia Syndrome.

Fibromyalgia syndrome (FMS) is a common chronic pain disorder associated with altered activity of neurotransmitters involved in pain sensitivity such as dopamine, serotonin, and noradrenaline. FMS may significantly impact an individual's functioning due to the presence of chronic pain, fatigue, and cognitive impairment. Dyscognition may be more disabling than the chronic pain but is mostly under-recognized. This study aimed to assess the potential co-occurrence of FMS and adult attention deficit hyperactivity disorder (ADHD), a chronic neurodevelopmental disorder also associated with impaired cognition and dopaminergic function. In a cross-sectional observational study, 123 previously confirmed FMS patients were screened for adult ADHD using the World Health Organization Adult ADHD Self Report scale v1.1. The Revised Fibromyalgia Impact Questionnaire (FIQ-R) was used to assess the impact of FMS. Cognitive assessment was based on self-report in accordance with the 2011 modified American College of Rheumatology criteria and the FIQ-R, respectively. Of the 123 participants, 44.72% (N = 55) screened positive for adult ADHD. Participants with both FMS and a positive adult ADHD screening test scored higher on the FIQ-R score (64.74, SD = 17.66, vs 54.10, SD = 17.10). Self-reported cognitive impairment was rated higher in the combined group (odds ratio = 10.61, 95% confidence interval; 3.77-29.86, P < 0.01). These results indicate that the co-occurrence of adult ADHD in FMS may be highly prevalent and may also significantly impact the morbidity of FMS. Patients with FMS should be assessed for the presence of adult ADHD.

The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients.

Fibromyalgia syndrome (FMS) is a rheumatologic disorder characterized by chronic widespread pain, fatigue and other symptoms. Baroreflex dysfunction has been observed in women with FMS. However, it is unknown whether the limited involvement of the baroreflex control during an orthostatic stimulus has some impact on the quality of life of the FMS patient. Therefore, the aim of the study is evaluate the relationship between the quality of life of the FMS patient and indexes of the cardiovascular autonomic control as estimated from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP). We enrolled 35 women with FMS (age: 48.8±8.9 years; body mass index: 29.3±4.3 Kg/m2). The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded during 15 minutes at rest in supine position (REST) and in orthostatic position during active standing (STAND). Traditional cardiovascular autonomic control markers were assessed along with a Granger causality index assessing the strength of the causal relation from SAP to HP (CRSAP→HP) and measuring the degree of involvement of the cardiac baroreflex. The impact of FMS on quality of life was quantified by the fibromyalgia impact questionnaire (FIQ) and visual analog score for pain (VAS pain). No significant linear association was found between FIQ scores and the traditional cardiovascular indexes both at REST and during STAND (p>0.05). However, a negative relationship between CRSAP→HP during STAND and FIQ score was found (r = -0.56, p<0.01). Similar results were found with VAS pain. In conclusion, the lower the degree of cardiac baroreflex involvement during STAND in women with FMS, the higher the impact of FMS on the quality of life, thus suggesting that Granger causality analysis might be clinically helpful in assessing the state of the FMS patient.

Impact of fibromyalgia syndrome on quality of life in patients with Behçet’s disease

Impact of fibromyalgia syndrome on quality of life in patients with Behçet’s disease