A Comparative Study of Fibromyalgia, Rheumatoid Arthritis, Spondyloarthritis, and Sjögren’s Syndrome; Impact of the Disease on Quality of Life, Psychological Adjustment, and Use of Coping Strategies

Abstract

Background Fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome are chronic rheumatic diseases with very different clinical characteristics, but which share symptoms such as pain and fatigue. The aim of the study was to examine the impact of the disease on psychological adaptation in fibromyalgia compared with other rheumatic diseases (rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome). Methods In a multicenter study, 165 women with rheumatic diseases (48 with fibromyalgia, 47 with rheumatoid arthritis, 47 with spondyloarthritis, 23 with Sjögren’s syndrome) completed the General Health Questionnaire–28 (emotional distress), Fatigue Severity Scale (fatigue), Fibromyalgia Impact Questionnaire (impact of the disease), Coping Strategies Questionnaire (coping), and Mini International Neuropsychiatric Interview (comorbidity with DSM IV axis-I disorders). We used the Kruskal-Wallis test, Mann-Whitney U test, and chi2 test to compare comorbid anxiety and depressive disorders and to compare the impact of the disease on patients’ mental well-being and daily life and adjustment (coping strategies). Results Anxiety and depressive disorders were more common in fibromyalgia patients; they had higher scores on impact of the disease, physical symptoms, pain, and fatigue than rheumatoid arthritis patients and reported more fatigue than patients with spondyloarthritis. Overall, they used more maladaptive coping strategies (less use of distancing from pain than patients with rheumatoid arthritis and spondyloarthritis, less use of ignoring pain sensations, and more use of catastrophizing than those with rheumatoid arthritis). No differences were found between fibromyalgia and Sjögren’s syndrome on impact and adjustment. Conclusions Compared with other rheumatic diseases, fibromyalgia has a greater impact on daily life; patients have more difficulty adjusting to the disease and generally use poorer strategies to cope with pain.

<p>Pain Diagnosis, Pain Coping, and Function in Individuals with Chronic Musculoskeletal Pain</p>

“…These findings are consistent with previous research comparing individuals with chronic pain due to different rheumatic illnesses, for which an effect of pain diagnosis was found for only coping responses of ignoring pain sensations and distancing from pain. 31 While previous research focusing the predictors of coping responses suggest that stressor-related characteristics (eg, level of perceived stress associated with the stressor or cluster of stressors) may be associated with the coping responses employed to cope with the stressor, it is possible that other pain-related characteristics and/or domainsbut not the etiology of paininfluence pain-coping responses. These include variables such as culture, context, gender, age, personality, and appraisals, all of which have been shown in previous studies to be associated with the way one copes with a given stressor.…”

“…Patients with a diagnosis of fibromyalgia were also excluded from the study, as recommended by the healthcare providers involved in the identification of prospective participants, due to both the uncertainty of fibromyalgia's etiology as well as the need to avoid confounding effects that might arise from the high comorbidity of this condition with depression and other psychopathologies. 30,31 The majority of the participants were women (n = 213, 66%). Mean age was 61.02 years (SD = 15.23, range = 18 to 90 years).…”

Associations of Cognitive Fusion and Pain Catastrophizing with Fibromyalgia Impact through Fatigue, Pain Severity, and Depression: An Exploratory Study Using Structural Equation Modeling

“…Thus, it has been argued that functional limitation in patients with FM and other pain conditions should be conceptualized within a more comprehensive biopsychosocial perspective [6]. In this line, fatigue and depression have been repeatedly associated with poorer functioning in people with FM [7,8], which explains why both were added as part of the newer diagnostic criteria published in 2010 by the American College of Rheumatology [9].…”

“…In the light of the previous literature [1,7,8,13,17], our goals is to test the hypothesized associations of pain catastrophizing, cognitive fusion, and FM symptom severity (pain, fatigue, and depression) in a theoretically-sound model that accounts for the contribution of these elements altogether in relation to functional limitation. We hypothesize that catastrophizing components and cognitive fusion will be associated with greater disability (see Figure 1).…”

The Role of Nonmedical Therapeutic Approaches in the Rehabilitation of Complex Regional Pain Syndrome

“…Other features include changes to limb temperature, colour, nail and hair growth and impaired limb function (see Table 1) [2•]. CRPS exhibits similar clinical manifestations as other rheumatology conditions, pain, fatigue and/or muscle weakness [3,4]; however, for CRPS, the pain cannot be explained by the pathology. It has two subtypes according to the absence (CRPS 1) or presence (CRPS 2) of an associated nerve lesion [1].…”