Total Fibromyalgia Impact Questionnaire Research Articles

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Revised Fibromyalgia Impact Questionnaire (FIQR) for Use in Arabic-Speaking Patients in Saudi Arabia.

Fibromyalgia (FM) is a complex and debilitating condition that significantly impacts patients' daily lives. The continuous assessment of the impact and severity of FM is essential to manage the condition effectively. Assessment tools in Arabic are lacking for use in Saudi Arabia, which might lead to ineffective management. This study aimed to translate and cross-culturally adapt and validate the Arabic version of the Revised Fibromyalgia Impact Questionnaire (FIQR). Following translation guidelines, 2 Arabic translators and 2 English-certified translators performed forward and backward translations of the FIQR. In a cross-sectional study design, the questionnaire was piloted with 5 participants and then subjected to cognitive interviews and psychometric analysis. Participants were FM patients recruited from a University Hospital in Riyadh and FM support groups in Saudi Arabia. The internal consistency, and reliability using the Cronbach α and interclass correlation coefficient (ICC) of 2-week test-retest, and criterion validity were evaluated. The results included a total of 42 participants with FM. Six minor modifications were made during the stepwise translation of the questionnaire. The Arabic version of the FIQR had good internal consistency and test-retest reliability, with a Cronbach α of 0.855 for the physical functioning domain, 0.663 for overall well-being, 0.803 for symptoms, and 0.895 for the total FIQR, and the Pearson correlation coefficient of the ICC for physical functioning was 0.769 (95% confidence interval (CI), 0.541-0.884) for the overall well-being domain, 0.555 (95% CI, 0.129-0.772) for the symptoms domain, and 0.720 (95% CI, 0.370-0.868) and 0.794 (95% CI, 0.579-0.899) for the total FIQR score (p < 0.001), respectively. The Arabic version of the FIQR is a valid, reliable, and practical tool for assessing the impact of FM on Arabic-speaking patients and potentially contributing to the improvement of FM outcomes.

The effect of myofascial release of the physiological chains on the pain and health status in patients with fibromyalgia, compared to passive muscle stretching and a control group: a randomized controlled clinical trial

Objective To explore the potential effectiveness of myofascial release compared to passive muscle stretching and to a control group in modulating pain intensity and health status in adults diagnosed with fibromyalgia (FM). Materials and Methods A preliminary randomized controlled clinical trial was conducted, consisting of eight weekly sessions. The participants were divided into three groups: myofascial release group (RG = 13), a muscle stretching group (SG = 13), and a control group (CG = 12), which received advice from a rheumatologist. The outcomes measured were the visual analogue pain scale (VAS), the fibromyalgia impact questionnaire (FIQ) (representing health status), and the number of painful areas. Univariate analyzes of covariance (ANCOVA) were performed at baseline, after 4 weeks (during treatment), after 8 weeks (post-treatment), and after 12 weeks (follow-up). The International Physical Activity Questionnaire (IPAQ), the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale (PCS) were included as covariates. Clinical trial registration number: NCT: 03408496. Results After eight weeks, the RG showed lower VAS scores compared to the CG (mean difference 95% CI: −5.10 to −1.26) and the SG (mean difference 95% CI: −4.9 to −0.23) with no difference between the SG and the CG. The total FIQ score for the RG was lower than the CG after 4 weeks (95% CI: −49.92 to −5.61), and 8 weeks (mean difference 95% CI: −52.72 to −15.73), although there was no difference between the RG and SG, as well as between the SG and CG, at both time points. The number of painful body areas was similar in all groups at the four time points. Conclusion Preliminary results suggest that the RG possibly showed greater improvements in pain intensity and health status compared to the CG, and possibly greater improvements in pain intensity compared to the SG.

Psychological variables associated with resistance to treatment with serotonin and noradrenaline reuptake inhibitors in fibromyalgia

ObjectiveThe treatment of fibromyalgia (FM) often offers only partial pain relief. Among the most effective drugs for FM pain are serotonin and noradrenalin reuptake inhibitors (SNRI). Few studies investigated the affective temperaments and personality features in FM. Our objective was to explore the associations between the affective temperaments, personality traits, schizotypy and response to SNRI treatment in FM. Methods60 FM patients: 30 responsive to SNRI (FM T[+]), 30 non-responsive to SNRI (FM T[−] and 30 healthy controls were recruited. Resistance to SNRI was defined as <30% pain reduction during at least 8-week treatment. Subjects were assessed by physician and filled self-report questionnaires: Temperament Scale of Memphis, Pisa and San Diego- autoquestionnaire, Ten Item Personality Inventory, Oxford-Liverpool Inventory of Feelings and Experiences and Fibromyalgia Impact Questionnaire (FIQ). ANOVA analysis and simple logistic regressions were used to examine the links between psychological variables and lack of response to SNRI. ResultsFM T[−] presented higher scores in total FIQ and in physical, work, well-being, pain, fatigue/sleep, stiffness domains than FM T[+]. FM T[−] showed higher levels of: irritable and anxious temperaments, neuroticism, schizotypy than FM T[+]. The levels of depressive, irritable and anxious temperaments, introversion, neuroticism and schizotypy were linked to lack of response to SNRI. ConclusionsFM T[+] and FM T[−] differ in clinical presentation and psychological features. The levels of affective temperaments, personality and schizotypal traits are associated with lack response to SNRI in FM.

Gender differences in the revised Fibromyalgia Impact Questionnaire: a pilot study.

Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with symptoms such as fatigue, sleep disturbances and cognitive impairment. Prevalence is higher in females but the application of the 2010/2011 and 2016 revision of the American College of Rheumatology (ACR) criteria reduced prevalence differences and the actual female:male ratio is approximately 3:1. Even if lately some studies have been conducted regarding FM gender differences, disease severity is still assessed using questionnaires, such as the Revised Fibromyalgia Impact Questionnaire (FIQR), designed and validated through a predominantly female sample. The aim of this pilot study was to compare the 21 items of the FIQR among male and female patients in order to evaluate the possible existence of a gender bias. In this case-control study, consecutive patients with a diagnosis of FM (2016 ACR criteria) were asked to answer an online survey, including demographic characteristics, disease variables and the Italian version of the FIQR. Among the 544 patients that compiled the questionnaire, 78 patients, 39 males and 39 females, matched for age and disease duration, were consecutively enrolled in order to compare their FIQR scores. The univariate analysis showed that total FIQR scores and physical function domain scores were significantly higher in females and, among the 21 items of the FIQR, the female group obtained significantly higher scores in 6 of them. Our results showed that female patients obtain significantly higher scores in the FIQR total score and physical function domain score, in particular in 5 out of the 9 sub-items of the FIQR physical function domain. These preliminary results indicate that the use of the FIQR as a severity index in male patients probably underestimates the disease impact in this group.

Cyberchondria and health anxiety in patients with fibromyalgia

Aim of the studyThe purpose of the study is to investigate the cyberchondria attitudes, health anxiety and their correlation with each other in Fibromyalgia Syndrome (FMS) patients.Subject or material and methods68 patients diagnosed with FMS according to the American College of Rheumatology (ACR) 2010 diagnostic criteria and 68 healthy individuals with similar sociodemographic characteristics and meeting the study criteria were included in the study. Sociodemographic Data Form, Cyberchondria Severity Scale (CSS), Fibromyalgia Impact Questionnaire (FIQ), and Health Anxiety Inventory-Short Version (HAI) were administered to all participants.ResultsThe sub-dimensions of the CSS total, distress, excessiveness, reassurance, and mistrust of medical professional and the HAI body sub-dimension and total score of the patient group were found to be significantly higher than the scores of the control group (p&lt;0.001). There is a significant positive correlation between HAI total score and FIQ score (p= 0.018) (r=.285). A positive and significant relationship was found between the CSS-total score and the HAI sub-dimensions and total score (p= 0.002, r=.377).DiscussionOur study shows that health anxiety and cyberchondria are high in patients with FMS and that disease severity and health anxiety increase in direct proportion. Due to these results, it may be wise to periodically check the cyberchondria and health anxiety levels of these patients and to include psychiatric view in the treatment of the patients.ConclusionsDoctors can refer patients who have health concerns and who have comorbid psychiatric symptoms for psychoeducation, as well as protect patients from uncontrolled anxiety by referring them only to reliable and accurate online sites.

Effect of vitamin B12 on the symptom severity and psychological profile of fibromyalgia patients; a prospective pre-post study

BackgroundFibromyalgia (FM) as a prototypical nociplastic pain condition displays a difficult therapeutic situation in many cases. Given the promising data on the effect of vitamin B12 in improving pain and cognitive functions in various nociplastic pain conditions, we aimed to determine the efficacy of 1000 mcg daily dose of oral vitamin B12 on the symptom severity and psychological profile of FM patients.MethodsThis open-label, pre-post study was performed on FM patients whose diagnoses were confirmed by a rheumatologist based on the 2016 American College of Rheumatology (ACR). Patients were instructed to take a daily dose of 1000mcg vitamin B12 for fifty days. Outcome measures including the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), 12-item Short-Form health survey (SF-12), and pain Visual Analog Scale (pain-VAS) were fulfilled by patients before and after the treatment.ResultsOf 30 eligible patients, 28 patients completed the study protocol. Patients were female with a mean age of 47.50 ± 8.47 years. FIQR scores in all domains improved significantly after treatment (total FIQR: 49.8 ± 21.86 vs 40.00 ± 18.36, p value < 0.01; function: 13.17 ± 7.33 vs 10.30 ± 5.84, p value: 0.01; overall: 10.32 ± 6.22 vs 8.25 ± 6.22, p value: 0.03; symptoms: 26.30 ± 10.39 vs 21.44 ± 8.58, p value < 0.01). Vitamin B12 also improved anxiety scores from 9.33 ± 4.30 to 7.70 ± 3.60, p value: 0.01. Depression, pain-VAS, and SF-12 didn’t improve following the treatment. The Generalized estimating equations (GEE) analysis showed the improvement in total FIQR score is not cofounded by the improvement of anxiety and patients’ baseline characteristics.ConclusionsThis study showed a short course of sublingual vitamin B12, 1000 mcg daily, significantly improves the severity of FM and anxiety score. We postulate that vitamin B12 has a strong potential to consider, at least, as adjunctive therapy of FM.Trial registrationThe study protocol was approved by the ethics committee of Guilan University of Medical Sciences (IR.GUMS.REC.1400.197) in accordance with the World Medical Association’s code of ethics (Declaration of Helsinki, revised in Brazil 2013), and registered at an ICMJE and WHO recognized registry of clinical trials (www.irct.ir) on 28/08/2021 (registration number: IRCT20200920048782N1).

Evaluation of Sexual Dysfunction in Female Patients with Fibromyalgia Syndrome

Objectives: The aim of our study is to determine the presence and quality of sexual function in women with fibromyalgia syndrome and to compare it with the normal population. Materials and methods: In our case-control study was conducted on sexually active 46 fibromyalgia patients who were diagnosed according to the American College of Rheumatology (ACR) criteria and 35 healthy control aged between 20-55. The data was collected with Beck Depression Inventory (BDI), Female Sexual Function Index (FSFI), Fibromyalgia Impact Questionnaire (FIQ) and Visual Analogue Scale (VAS). The clinical characteristics of both groups were compared and the relationships between FSFI and clinical parameters were evaluated. Results: Both groups were similar in terms of age, duration of marriage, number of children, family type and educational level. The mean duration of complaints in women with fibromyalgia was 5.62 (3.45) years, FIQ score was 59.8 (12.2) and VAS score was 7 (2). FSFI score was 13.2 (8.1) in group 1 and 32.1 (5.2) in group 2 (P<0.05). The mean scores of FIQ, BDI and VAS in group 1 were significantly higher than those in group 2 (P<0.05). In addition, a significant negative correlation was determined between the total FSFI score and FIQ and BDI scores in group 1. Conclusion: Negative effects of sexual dysfunction on female patients should be considered when evaluating fibromyalgia. It should be noted that sexual functon assessment must be a part of fibromyalgia syndrome treatment. Further studies are needed to elucidate the relationship between fibromyalgia and sexual dysfunction

The plasma microRNA levels and their relationship with the general health and functional status in female patients with fibromyalgia syndrome.

Objectives The aim of this study was to identify the plasma level of micro-ribonucleic acid (microRNA) expressions and the relationship between plasma microRNA levels with the general health and functional status in female patients with fibromyalgia syndrome (FMS).Patients and methods Thirty-five female patients (mean age: 42.0±11.8 years; range, 21 to 62 years) diagnosed as FMS and 35 sex-and age-matched healthy controls (mean age: 43.7±8.8 years; range, 21 to 56 years) were enrolled in the study. MicroRNA measurements of the participants in plasma were carried out by using the quantitative polymerase chain reaction (qPCR). A total of 11 plasma levels of microRNA expressions were examined in both groups. The general health and functional status of the patients and controls were assessed by the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form-36 (SF-36) scale.Results No significant difference was observed between the plasma levels of microRNA expressions in patients with FMS and healthy controls. The plasma level of miR-320a expression was found to be negatively correlated with the total FIQ score in female patients with FMS (p=0.05, r=-0.34). Negative correlations were also detected between the plasma level of miR-320a and miR-320b expressions and the subscale score of SF-36 physical function in female patients with FMS (p=0.01, r=-0.43 and p=0.01, r=-0.43, respectively). A strong positive correlation was found between miR-142-3p and the subscale score of SF-36 mental symptom score in female patients with FMS (p<0.001, r=1.00).Conclusion The expression levels of microRNAs in plasma between female patients with FMS and controls were not significantly different. Only plasma levels of miR-320a, miR-320b, and miR-142-3p expressions were associated with the general health, functional status, and mental symptom score in female patients with FMS.

Attention-deficit hyperactivity disorder symptoms and quality of life in female patients with fibromyalgia

Background/aim The present study aimed to determine the association between attention-deficit hyperactivity disorder (ADHD) symptoms severity, fibromyalgia (FM) severity, and QoL.Materials and methodsWhile the FM group consisted of 113 (74%) patients, the control group consisted of 40 (26%) individuals. FM symptom severity, ADHD symptom severity, and QoL were evaluated using the fibromyalgia impact questionnaire (FIQ), adult ADHD self-report scale (ASRS), and World Health Organization quality of life scale-brief version (WHOQOL-BREF), respectively. ResultsIt was found that the FM group had significantly higher scores on the ASRS than the control group (p < 0.05). There was a significant difference in FIQ scores and three WHOQOL-BREF domain scores between the FM alone and comorbid FM/high probability of ADHD groups (p < 0.05). We found a negative correlation between ASRS total scores and all other scale scores (except for the social relationships domain score of the WHOQOL-BREF) and a positive correlation between ASRS total scores and FIQ scores in FM patients. ADHD scores would mediate the relationship between depression severity and QoL.ConclusionsOur findings indicated that the presence of ADHD symptoms was related to greater FM symptom severity and poorer QoL. Also, ADHD scores would mediate the relationship between depression severity and QoL.

Feasibility and Acceptability of Heart Rate Variability Biofeedback in a Group of Veterans with Fibromyalgia.

Objectives: To determine the feasibility and acceptability of a heart rate variability biofeedback (HRVB) protocol in a focus group of Veterans with fibromyalgia (FM). Design: A multimethod feasibility and acceptability study. Settings/location: A Veterans Health outpatient pain medicine clinic in the southern United States. Subjects: The researcher enrolled seven women and three men between the ages of 33 and 68 years with a diagnosis of FM. Interventions: Participants practiced HRVB on the emWave2 at home for 20 min twice daily for 7 weeks. Outcome measures: Feasibility to adhere to the HRVB protocol was measured using the practice frequency and time (minutes) data collected from the emWave2. The author compared the individual reports from participants with the Credibility/Expectancy Questionnaire to measure the acceptability of the intervention. In addition, the principal investigator evaluated data from the Short-form McGill Pain Questionnaire (SFMQ) and the Revised Fibromyalgia Impact Questionnaire (FIQR) at the baseline and weekly study visits for a signal of efficacy for pain control, functional status, and quality of life (QOL). Results: The majority of participants (80%) expected 50% or more improvement in their pain, and (70%) felt HRVB would reduce their FM-related pain by 50%-80%. The mean daily practice frequency rate was 0.80. The mean practice duration was 19.36 min. Pain score differences from the SFMQ were insignificant preintervention and postintervention. The mean total FIQR scores postintervention improved by 18.1 points. Conclusions: Findings suggest twice-daily HRVB practice protocol is not feasible. However, 20-min HRVB sessions were feasible and acceptable. Improved FIQR scores post-treatment suggest HRVB may be an effective strategy to improve functional status and QOL for Veterans with FM. ClinicalTrials.gov ID: Pro00079144.

Fibromiyalji Sendromunda Hastalık Şiddeti ile Beden Algısı, Duygudurum Bozukluğu ve Yaşam Kalitesi Arasındaki İlişki

Objective: The present study aimed to determine the correlation between fibromyalgia (FM) severity and body image perception and to investigate its impact on quality of life and mood. Material and Methods: The study participants included 18-65 years old 141 female FM patients and 30 healthy female subjects. Fibromyalgia impact questionnaire (FIQ), body image questionnaire (BIQ), Beck depression inventory (BDI), Beck anxiety inventory (BAI), and quality of life survey- short form (SF-36) were applied to all subjects. In order to define the severity of FM, cases were compared based on total FIQ scores and categorized as mild (<39), moderate (40-59), severe (≥60) and control groups. Results: There were statistically significant positive correlations between FM severity and BIQ, BDI, BAI scores, and statistically significant negative correlations between FM severity and physical functioning, role-physical, pain, general health, vitality, role- emotional and mental health scores. Multivariate regression analysis demonstrated that BIQ, role-physical, pain, general health and BDI values significantly contributed to fibromyalgia severity. Conclusion: The results of our study show that body image, mood and quality of life are affected negatively in FM patients and FM severity has an important effect on anxiety, depression, body image and quality of life.

Determining the Minimal Clinically Important Difference for 6-Minute Walk Distance in Fibromyalgia.

The aim of this study was to estimate the minimal clinically important difference (MCID) for 6-min walk distance (6MWD) in patients with fibromyalgia. Data from a recently completed trial that included 187 patients who completed the 6-min walk test, Fibromyalgia Impact Questionnaire (FIQ), and Short-Form 36 (SF36) at 12 and 36 wks were used to examine longitudinal changes in 6MWD. An anchor-based approach that used linear regression analyses was used to determine the MCID for 6MWD, using the total FIQ score (FIQ-Total) and SF36-physical function domain as clinical anchors. The mean (SD) change in 6MWD from baseline to week 36 was 34.4 (65.2) m (P < 0.001). The anchor-based MCIDs for the 6MWD were 156 and 167 m for the FIQ and SF36-physical function domain, respectively. These MCIDs correspond with clinically meaningful improvements in FIQ (14% reduction) and SF36-physical function domain (10-point increase). The MCID for 6MWD in patients with fibromyalgia was 156 to 167 m. These findings provide the first evidence of the change in 6MWD that is perceived by patients to be clinically meaningful. Further research using other MCID calculation methods is needed to refine estimates of the MCID for 6MWD in patients with fibromyalgia.

Fibromyalgia and Its Clinical Relevance in Renal Transplant Recipients.

Objective: Fibromyalgia (FM) syndrome was associated with various pathophysiologic mechanisms including oxidative stress, inflammation, coronary heart disease, left ventricular function and endothelial dysfunction. Our aim was to determine the prevalence of FM in renal transplant recipients and to identify possible links between FS and various clinical and laboratory parameters. Methods:Ninety nine kidney transplant recipients with normal graft functions (37.1±10.8 yrs, 67 male, 51.98±16.3 months post-transplantation period) were enrolled. All subjects completed the Fibromyalgia Impact Questionnaire (FIQ) and patients were evaluated with the total FIQ score and their physical impairmant score (PIS:0-10) and stiffness subscales. The biochemical and clinical parameters in the first year of post transplantation period were retrospectively recorded and graft function is evaluated with the yearly decline in eGFR. Cardiovascular parameters including body composition analyses, ambulatory blood pressure monitoring data(ABPM), pulse wave velocity (Pwv) were cross-sectionally analyzed. Results: Mean FIQ score for the whole group was 21.4±14.7. Eight patients had FIQ score >50 and these patients had significantly higher LVMI than patients with lower FIQ score (p:0.048). Patients were divided into two groups;Group 1 PIS ≥5, n:50 and group 2 PIS<5, n:49. Patients with higher PIS had significantly higher serum creatinine (p:0.047) and lower eGFR values (p:0.008) than group 2 patients. In ABPM, group 1 patients had significantly higher overall diastolic (p:0.015) and mean arterial BP (p:0.048) than group 2. Physical impairment score was positively correlated with serum CRP levels (p:0.024, r:.227). Patients were also evaluated with the stiffness score (SS) as group1 patients with (n:41) or group 2 patients without (n:58) stiffness. Patients with stiffness had significantly higher office sistolic (p:0.027) and diastolic BP (p:0.044) levels than patients without stiffness. BMI (p:0.033) and saggittal abdominal diameter (p:0.05) were significantly higher in patients with stiffness. Yearly decline in eGFR levels were significantly higher in patients with higher FIQ (7.6% vs. 9.4%, p:.0001) than other patients. Conclusion: FM in renal transplant recipients was closely related with adverse clinical outcome like hypertension, arterial stiffness, obesity and renal graft dysfunction.

FRI0569-HPR The Effectiveness of Education and Aerobic Exercise in Higher Functioning Patients with Fibromyalgia: an Evaluation of A New Service

BackgroundFibromyalgia syndrome (FMS) is characterised by chronic widespread pain, fatigue and reduced physical function. Exercise has positive effects on physical function, fatigue and well-being in FMS1. However, patients find it...

Evaluation of the Interdisciplinary PSYMEPHY Treatment on Patients with Fibromyalgia: A Randomized Control Trial

Fibromyalgia (FM) is a chronic disorder that can have a devastating effect on patients' lives. This study assessed the efficacy of a 6-week interdisciplinary treatment that combines coordinated PSYchological, Medical, Educational, and PHYsiotherapeutic interventions (PSYMEPHY) compared with standard pharmacologic care. The study was a randomized controlled trial (54 participants in the PSYMEPHY group and 56 in the control group [CG] ) with follow-up at 6 months. PSYMEPHY patients were also assessed at 12 months. The main outcomes were changes in total Fibromyalgia Impact Questionnaire (FIQ) score, pain, fatigue, morning tiredness, anxiety, and use of pain coping strategies as measured by the FIQ, the visual analog scale, and the Coping with Chronic Pain Questionnaire. After the 6-month assessment, patients in the CG were offered the PSYMEPHY treatment, and completed all of the instruments immediately after treatment, and at 6- and 12-month follow-up visits (N = 93). Subjects received therapy at two different outpatient clinical locations. Fibromyalgia patients. Six months after the intervention, significant improvements in total FIQ score (P = 0.04), and pain (P = 0.03) were seen in the PSYMEPHY group compared with controls. Twelve months after the intervention, all patients in the PSYMEPHY group maintained statistically significant improvements in total FIQ score, and pain, and showed an improvement in fatigue, rested, anxiety, and current pain compared with baseline. Data from the control patients who underwent the PSYMEPHY intervention corroborated the initial results. This study highlights the beneficial effects of an interdisciplinary treatment for FM patients in a hospital pain management unit. A 6-week interdisciplinary intervention showed significant improvement in key domains of fibromyalgia, as quality of life, pain, fatigue, rested, and anxiety at 12 months.

Quetiapine extended-release (Seroquel-XR) versus amitriptyline monotherapy for treating patients with fibromyalgia: a 16-week, randomized, flexible-dose, open-label trial

Previous open-label studies have suggested that quetiapine could be a valuable alternative for treating fibromyalgia. This study aims to compare the efficacy and tolerability of extended-release quetiapine with amitriptyline for treating fibromyalgia. This study was a randomized, open-label, flexible-dose, non-inferiority trial. Patients with fibromyalgia were randomized to receive quetiapine extended-release (XR) (N = 45) (50 to 300 mg daily) or amitriptyline (N = 45) (10 to 75 mg daily) for 16 weeks. The primary endpoint was the change from baseline to endpoint in the Fibromyalgia Impact Questionnaire (FIQ) total score; the non-inferiority threshold was established at 8 points. The secondary outcomes included sleep quality, anxiety, depression, and quality of life. Twenty-two (49%) patients in the quetiapine group and 34 (76%) patients in the amitriptyline group completed the study. We found a reduction of 9.8 points in the total FIQ score at the endpoint for the quetiapine-treated patients compared to 13.9 points for the amitriptyline-treated patients, for a difference of 4.14 points (80% confidence interval (CI) -0.70 to 8.98). No significant differences were found between the quetiapine XR and amitriptyline groups for any of the secondary outcomes. The proportion of patients discontinuing treatment due to adverse events was higher in the quetiapine group (n = 14, 31.1%) than the amitriptyline group (n = 3, 6.6%). Our results appear to indicate that quetiapine XR does not provide similar efficacy to amitriptyline for treating patients with fibromyalgia. Quetiapine XR had a worse tolerability than amitriptyline in this population, possibly due to a relatively high starting dose.

Short-term change of handgrip strength after trigger point injection in women with muscular pain in the upper extremities.

ObjectiveTo determine overall handgrip strength (HGS), we assessed the short-term change of HGS after trigger point injection (TPI) in women with muscular pain in the upper extremities by comparison with established pain scales.MethodsThe study enrolled 50 female patients (FMS with MPS group: 29 patients with combined fibromyalgia [FMS] and myofascial pain syndrome [MPS]; MPS group: 21 patients with MPS) who presented with muscular pain in the upper extremities at Konyang University Hospital. In addition, a total of 9 healthy women (control group) were prospectively enrolled in the study. We surveyed the three groups using the following established pain scales: the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), and the Short Form McGill Pain Questionnaire (MPQ). HGS was measured in both hands of study participants using a handgrip dynamometer. We performed TPI (0.5% lidocaine, total 10 mL, injected at the pain site of upper extremities). After 20 minutes, we remeasured the patient's HGS and MPQ score.ResultsANOVA analysis was conducted among groups. Based on Tukey multiple comparison test, the majority of FIQ and SF-36 subscales, total FIQ and SF-36 scores, MPQ and HGS were significantly different between FMS with MPS and the other groups. There was no statistically significant difference between MPS and control groups. Higher HGS was positively associated with enhanced physical function, negatively associated with total FIQ and MPQ scores, and positively associated with the total SF-36 score calculated using Spearman correlation. Post-TPI MPQ decreased and HGS increased. In patient groups, a negative correlation was found between MPQ and HGS.ConclusionThe HGS test might potentially be a complementary tool in assessing the short-term treatment effects of women with muscular pain in the upper extremities.

Interdisciplinary Treatment of Patients with Fibromyalgia: Improvement of Their Health‐Related Quality of Life

To assess whether an interdisciplinary intervention is more effective than usual care for improving the health-related quality of life (HRQoL) among patients with fibromyalgia (FM), and to identify variables that were predictors of improvement in HRQoL. In a randomized controlled clinical trial carried out on an outpatient basis in a hospital pain management unit, 153 patients with FM were randomly allocated to an experimental group (EG) or a control group (CG). Participants completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6months after the intervention. The EG received an interdisciplinary treatment (12 sessions for 6weeks) which consisted of coordinated psychological, medical, educational, and physiotherapeutic interventions while the CG received standard-of-care pharmacologic treatment. Descriptive statistics, ANOVA, Chi square and Fisher tests and generalized linear models were used for data analysis. Six months after the intervention, statistically significant improvements in HRQoL were observed in physical functioning (P=0.01), pain (P=0.03) and total FIQ score (P=0.04) in the EG compared to the CG. The number of physical illnesses was identified as a predictor for improvement. This interdisciplinary intervention has shown effectiveness in improving the HRQoL of this sample of patients with FM. The number of physical illnesses was identified as a predictor of that improvement.

Adjuvant Use of Melatonin with Fluoxetine for Management of Fibromyalgia

Fibromyalgia (FMS) is a chronic musculoskeletal disorder characterized by generalized muscular pain and tenderness at specific anatomical sites. Although melatonin was effective in treating the pain associated with this syndrome, no defined clinical evidence supports this claim. The present study was designed to evaluate the clinical significance of using melatonin, alone or in combination with fluoxetine in FMS. A double-blind clinical study was conducted on 45 patients with FMS randomized into 4 groups; group A, treated with fluoxetine 20mg/day alone; group B, treated with melatonin 5mg alone; group C, treated with combination of fluoxetine 20 mg+3 mg melatonin; group D treated with combination of fluoxetine 20 mg+5 mg melatonin. Both fluoxetine and melatonin were given once daily in the morning and night time respectively for 8 weeks. Each patient clinically evaluated using Fibromyalgia Impact Questionnaire (FIQ). Serum levels of serotonin, malondialehyde and nitric oxide were also evaluated. Using melatonin (3 and 5mg/day) in combination with 20mg/day fluoxetine significantly decreased total FIQ score values; the combination therapy significantly decreased serum serotonin level associated with reduction in the oxidative stress parameters (MDA and NO). In conclusion, adjuvant use of melatonin with fluoxetine improves the biochemical and clinical parameters of FMS patients.

The Effects of Fibromyalgia Syndrome on Female Sexuality: A Controlled Study

Fibromyalgia may have negative effects on sexual function in women. To evaluate the sexuality of women with fibromyalgia and healthy control subjects, and to investigate the relation between sexuality and clinical parameters of fibromyalgia. Female Sexual Function Index (FSFI), Tender Points Count (TPC), Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire (FIQ), and Visual Analog Scale (VAS). Clinical evaluation and surveys were done with 126 women with fibromyalgia and 132 healthy women. Patients with fibromyalgia had higher BDI scores and lower frequency of sexual intercourse than control subjects. The mean FSFI scores (total and all domains) were significantly lower in patients with fibromyalgia than control subjects. Mean FSFI scores (total and most domains) were significantly lower in patients with fibromyalgia who had BDI score≥17 than those who had BDI score<17. In women with fibromyalgia, a significant negative correlation was noted between total FSFI score, and both FIQ and BDI scores. Fibromyalgia has negative effects on female sexual function that are aggravated by depression.