The objective of the study was to analyse the impact of fibromyalgia (FM) on health-related quality of life (HRQOL) and to identify clinical and psychological factors associated with the disease. A cross-sectional study was conducted with adult Portuguese women with FM. Analysed data were demographic, clinical and psychological variables and HRQOL: SF-36 and Fibromyalgia Impact Questionnaire (FIQ). The relationship between HRQOL and the other variables was made with a bivariate analysis. To assess the relative contribution of clinical and psychological variables, a series of multiple regression analyses were designed and made. The study sample consisted of 76 women with FM (49.61 ± 10.07 years). All dimensions of HRQOL were affected in FM, especially Physical Functioning, Physical Role Functioning and General Health. The mean FIQ total score was 68.59 ± 17.54, and 40 patients (53%) presented scores ≥70. Pain intensity, assessed by a 10-cm visual analogue scale (VAS), was a significant predictor of HRQOL in expressing association with FIQ and all dimensions of SF-36, except Emotional Role Functioning. Anxiety (Hospital Anxiety and Depression Scale (HADS)) was a significant predictor of the Mental Component and General Health (SF-36). Depression (HADS) was related with Vitality, Mental Health and FIQ. Emotion-focused coping was related with General Health and Emotional Role Functioning, and social support (Satisfaction with Social Support Scale (ESSS)) was related with the Social Functioning. These clinical and psychological variables explained an acceptable proportion of variability (R (2)), ranging from 31.3% on Emotional Role Functioning to 70.6% on FIQ, except for Physical Role Functioning (R (2) = 6.1). FM has a negative impact on both general and specific dimensions of HRQOL, especially the physical dimensions. Pain intensity, anxiety and depression symptoms and the emotion-focused coping are the most relevant explanatory variables of the impact of FM on HRQOL.

Previous studies show controversial results regarding the influence of age on health-related quality of life (HRQOL) in patients with Fibromyalgia (FM). While some studies suggest that elderly patients have a worse HRQOL when compared with younger patients, others did not find differences according to age. The aim of the study was to analyse the impact of FM on HRQOL as far as patients' age is concerned. A cross-sectional study was conducted with 76 adult Portuguese women with FM between 22 and 75 years ([Formula: see text]; SD = 10.07). The HRQOL was assessed through the generic questionnaire Short-Form 36 Health Survey (SF-36). To this study, we considered the direct scores on each dimension that encompasses the SF-36, and standardized scores of each dimension by age and gender, using Portuguese normative data. Data regarding clinical and psychological variables (anxiety, depression and social support) were also collected. Of the total sample, 11 patients (14.5 %) had <39 years, 54 patients (71 %) had between 40 and 59 years and 11 subjects (14.5 %) had 60 years or more. There were no differences between the three patient groups in any of the clinical and psychological variables considered, and the same lack of differences was observed in the SF-36 direct scores. Nevertheless, when the analysis was made using the SF-36 standardized scores, the patients over 60 years presented a significantly lower deterioration on physical (Physical Function, Role Physical and General Health) and social dimensions when compared with patients under 59 years, on Vitality when compared with patients under 39 years, and on Body Pain when compared to patients with age between 40 and 59 years. Regarding mental dimensions, no differences were found in the three age groups. In conclusion, it is important to control age effect on HRQOL to determine the specific impact of FM. Controlling the age effect on the HRQOL with standardized scores, elderly women with FM (≥60 years) have less impact of the disease on the physical and social dimensions of the HRQOL than younger patients.

The aim of this study is to analyze the relationship between socio-demographic, clinical and psychosocial variables in patients with Type 2 Diabetes and to establish comparative patterns between genders with this disorder.Patients from a primary care center were assessed through a researcher design form and through the HADS, the ESSS and the PSQI. A total of 90 patients with Type 2 Diabetes were enrolled in this study (50% women), with a mean age of 56.67±6.41 years. The HADS depression presented a score of 3.77±2.98 and 6.70% of the sample revealed depression symptoms. As to anxiety, the HADS presented scores of 7.27±5.07 with 36.60% of the subjects revealing anxiety symptoms. Regarding social support, the results were positive and similar between genders. When it comes to sleep, the sample presented a PSQI of 8.68±2.87, with 73.30% of patients revealing poor sleep quality and 24.40% showing a sleep disorder. When comparing genders, women had higher anxiety (♀ 9.73±5.58; ♂ 4.80±2.91; p=0.000) and depression scores (♀ 4.26±2.69; ♂ 3.26±3.19; p=0.026), and worse sleep quality (♀ 9.88±7.46; ♂ 7.46±2.34; p=0.000).In conclusion, we can state that anxiety symptoms are very prevalent in patients with Type 2 Diabetes and women are more vulnerable to anxiety, depression symptoms and poor sleep quality.

Background The ‘funnel effect’ of Fibromyalgia (FM) assumes that as patients access healthcare services, they present greater severity and a more complex clinical situation than individuals with FM from the general population, but the studies comparing patients treated in different levels of healthcare are scarce. The aim of this study was to analyse the ‘funnel effect’ hypothesis by comparing patients from secondary and tertiary healthcare services. Methods A cross‐sectional sample of female patients was selected in secondary (rheumatology practices ‐ RP) and in tertiary healthcare (chronic pain clinics ‐ CPC). Information about sociodemographic, clinical and psychological characteristics was collected and health related quality of life (HRQL) was assessed. Results In total, 55 patients from RP and 60 patients from CPC were included in the comparison. Patients from CPC revealed a worst clinical status (higher number of tender points, medical visits and comorbidity), more somatic symptoms (pain and daytime dysfunction levels) and worst emotional status (more anxiety) than patients from RP. Patients attending CPC also revealed a worst HRQL than RP patients although this difference was mediated by the differences in clinical and psychological variables. Conclusions Our study supports the ‘funnel effect’ hypothesis among patients of different healthcare levels, with patients from tertiary healthcare services revealing worst clinical status, more somatic and psychological symptoms, and worst HRQL than patients from secondary healthcare services. Significance The worst clinical and psychological status and poorer quality of life in the patients from tertiary healthcare (chronic pain clinics) in relation to the patients from secondary healthcare (rheumatology practices) must be taken into account to design studies that assess any of these aspects, to a proper analysis and interpretation of the data, and to define the scope of its generalization, as data from different clinical settings are not directly comparable.

In the version of the article initially published, the name of the second author was incorrectly presented. Maria Isabel Vázquez Rodríguez name appears correctly above and below.