Functional Status, Quality of Life, and Costs Associated With Fibromyalgia Subgroups

Luciano, Juan V.; Forero, Carlos G.; Cerdà-Lafont, Marta; Peñarrubia-María, Maria Teresa; Fernández‐Vergel, Rita; Cuesta‐Vargas, Antonio; Ruiz, José Manuel Hita; Rozadilla-Sacanell, Antoni; Sirvent-Alierta, Elena; Santo-Panero, Pilar; Garcı́a-Campayo, Javier; Serrano‐Blanco, Antoni; Pérez‐Aranda, Adrián; Rubio-Valera, María

doi:10.1097/ajp.0000000000000336

Cited by 34 publications

(29 citation statements)

References 48 publications

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“…The first study included a sample of 229 patients (ie, Sample 1) and the second study comprised a sample of 160 patients (ie, Sample 2). A detailed description of both studies’ protocols and inclusion/exclusion criteria can be found elsewhere . Of the total sum of patients, only those reporting severe levels of pain were included in the present study ( n = 385).…”

Section: Methodsmentioning

confidence: 99%

“…A detailed description of both studies' protocols and inclusion/exclusion criteria can be found elsewhere. 12,13 Of the total sum of patients, only those reporting severe levels of pain were included in the present study (n = 385). Following the methodology used by Suso-Ribera et al, 14 a score of 7 or higher in the pain intensity item of the Revised Fibromyalgia Impact Questionnaire (FIQR; item 12: "please indicate the intensity of the pain in the last 7 days, where 0 is no pain and 10 is unbearable pain") was used as a cut-off to select patients with severe pain levels.…”

Section: Participants and Proceduresmentioning

confidence: 99%

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Patients With Fibromyalgia Reporting Severe Pain but Low Impact of the Syndrome: Clinical and Pain‐Related Cognitive Features

et al. 2019

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Background Fibromyalgia (FM) is a prevalent and highly disabling chronic pain syndrome. However, differences among patients regarding how pain impacts on daily life are remarkable. The main aim of this study was to identify clinical and pain‐related cognitive variables characterizing patients reporting high adaptability despite experiencing severe chronic pain. Methods Two hundred and eighty‐three Spanish patients with FM with high levels of pain were classified into 2 groups: (1) those reporting low impact of the syndrome, and (2) those with moderate‐to‐high impact. Perceived stress, anxiety, and depressive symptoms along with pain catastrophizing, psychological inflexibility, and perceived control over pain were evaluated. Differences in sociodemographics, years with FM, past/current major depressive disorder comorbidity, and health‐related economic costs (ie, medications, use of medical services, lost productivity due to sick leave) were also assessed. Stepwise logistic regression analyses predicting group membership from clinical variables and pain‐related cognitive processes as predictors were performed. Results Lower stress, anxiety, and depressive symptoms, along with reduced pain catastrophism, psychological inflexibility, and perceived control over pain, were found in the low‐impact group. Significant predictors of group membership (low‐impact vs. moderate‐to‐high impact) in regression analyses were “cognitive fusion” (psychological inflexibility), “helplessness” (pain catastrophizing), and depressive symptomatology, together with pain intensity and other FM symptoms. Conclusions The present study provides further evidence on resilience resources in chronic pain by identifying some variables (ie, reduced depressive symptomatology, pain catastrophizing, and psychological inflexibility) differentially characterizing a profile of patients with FM who are especially able to adapt to high levels of pain.

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Section: Methodsmentioning

confidence: 99%

Section: Participants and Proceduresmentioning

confidence: 99%

Patients With Fibromyalgia Reporting Severe Pain but Low Impact of the Syndrome: Clinical and Pain‐Related Cognitive Features

et al. 2019

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“…In the present study, we utilized the dataset from the Fibromyalgia Subtypes study (Luciano et al, 2016 ) and early-stage data from the EUDAIMON study (Feliu-Soler et al, 2016 ). Study data are available from the corresponding author.…”

Section: Methodsmentioning

confidence: 99%

Psychometric Properties of the Cognitive Emotion Regulation Questionnaire (CERQ) in Patients with Fibromyalgia Syndrome

et al. 2017

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Given that Fibromyalgia Syndrome (FMS) is associated with problems in emotion regulation, the importance of assessing this construct is widely acknowledged by clinical psychologists and pain specialists. Although the Cognitive Emotion Regulation Questionnaire (CERQ) is a self-report measure used worldwide, there are no data on its psychometric properties in patients with FMS. This study analyzed the dimensionality, reliability, and validity of the CERQ in a sample of 231 patients with FMS. Given that “fibrofog” is one of the most disabling FMS symptoms, in the present study, items in the CERQ were grouped by dimension. This change in item presentation was conceived as an efficient way of facilitating responses as a result of a clear understanding of what the items related to each dimension are attempting to measure. The following battery of measures was administered: the CERQ, the Revised Fibromyalgia Impact Questionnaire, the Pain Catastrophizing Scale, the Center for Epidemiologic Studies Depression Scale, and the State-Trait Anxiety Inventory. Four models of the CERQ structure were examined and confirmatory factor analyses supported the original factor model, consisting of nine factors—Self-blame, Acceptance, Rumination, Positive refocusing, Refocus on planning, Positive reappraisal, Putting into perspective, Catastrophizing, and Other-blame. There was minimal overlap between CERQ subscales and their internal consistency was adequate. Correlational and regression analyses supported the construct validity of the CERQ. Our findings indicate that the CERQ (items-grouped version) is a sound instrument for assessing cognitive emotion regulation in patients with FMS.

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“…The heterogeneity of fibromyalgia has led to the proposal of the existence of subgroups of patients [88]; however, analgesic drug development is based on the mean responses of groups of patients with the same condition given the same drug and dose, with individual subjects or subgroups of the patient population given little consideration [89]. With such a heterogeneous condition, effectiveness is going to be dependent on multimodal pharmacology, as exhibited by amitriptyline.…”

Section: Discussionmentioning

confidence: 99%

A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia

Lawson

2017

Biomedicines

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Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ) score, which is a quality of life assessment. The multimodal profile of the mechanisms of action of amitriptyline include monoamine reuptake inhibition, receptor modulation and ion channel modulation. Several of the actions of amitriptyline on multiple nociceptive and sensory processes at central and peripheral locations have the potential to act cumulatively to suppress the characteristic symptoms of fibromyalgia. Greater understanding of the role of these mechanisms of action of amitriptyline could provide further clues to the pathophysiology of fibromyalgia and to a preferable pharmacological profile for future drug development.

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Functional Status, Quality of Life, and Costs Associated With Fibromyalgia Subgroups

Abstract: We identified 3 distinct profiles which accounted for the heterogeneity of FM patients. Our findings might help to design tailored interventions for FM patients.

Cited by 34 publications

References 48 publications

Patients With Fibromyalgia Reporting Severe Pain but Low Impact of the Syndrome: Clinical and Pain‐Related Cognitive Features

Patients With Fibromyalgia Reporting Severe Pain but Low Impact of the Syndrome: Clinical and Pain‐Related Cognitive Features

Psychometric Properties of the Cognitive Emotion Regulation Questionnaire (CERQ) in Patients with Fibromyalgia Syndrome

A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia

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