Impact of IPDE-SQ personality disorders on the healthcare and societal costs of fibromyalgia patients: a cross-sectional study

Abstract

BackgroundData is lacking on comorbid personality disorders (PD) and fibromyalgia syndrome (FMS) in terms of prevalence, and associated healthcare and societal costs. The main aim of this study was to assess the prevalence of PD in FMS patients and to analyse whether the presence of comorbid PD is related to worse functional impairment and greater healthcare (medical visits, drug consumption, and medical tests) and societal costs.MethodsA cross-sectional study was performed using the baseline data of 216 FMS patients participating in a randomized, controlled trial carried out in three primary health care centres situated in the region of Barcelona, Spain. Measurement instruments included the International Personality Disorder Examination - Screening Questionnaire (IPDE-SQ), the Fibromyalgia Impact Questionnaire (FIQ), the Client Service Receipt Inventory (CSRI), and a socio-demographic questionnaire.ResultsMost patients (65 %) had a potential PD according to the IPDE-SQ. The most prevalent PD were the avoidant (41.4 %), obsessive-compulsive (33.1 %), and borderline (27 %). We found statistically significant differences in functional impairment (FIQ scores) between FMS patients with potential PD vs non-PD (59.2 vs 51.1; p < 0.001). Multivariate regression analyses revealed that higher FIQ total scores and the presence of potential PD were related to more healthcare costs (primary and specialised care visits).ConclusionsAs expected, PD are frequent comorbid conditions in patients with FMS. Our results suggest that the screening of comorbid PD in patients with FMS might be recommendable in order to detect potential frequent attenders to primary and specialised care.

Prevalence of personality disorders in patients with fibromyalgia: a brief review

“…Table 1 summarizes the results from the 10 reviewed articles, in descending chronological order. Obsessive-compulsive PD was found to be the most common in three samples (Rose et al, 2009;Uguz et al, 2010;Pando Fernández, 2011), Avoidant PD was the most common in two samples (Fu et al, 2015;Gumà-Uriel et al, 2016), Histrionic PD was the most common in two samples (Cerón Muñoz et al, 2010;Kayhan et al, 2016), and Borderline PD was the most common in one sample (Thieme et al, 2004). Two studies did not report the prevalence of specific PDs (Martinez et al, 1995;Garcia-Fontanals et al, 2014).…”

<p>Psychological impact of fibromyalgia: current perspectives</p>

“…Some personality disorders appear to be more prevalent in FMS patients than in the general population, including obsessive-compulsive personality disorder,115,116 borderline personality,94 avoidant personality disorder,117,118 and histrionic personality disorder 115. Some studies have observed a predominance of certain personality traits in FMS, such as perfectionism,119,120 alexithymia,84,121 neuroticism,27,122,123 psychocitism,123 avoidant personality traits,115,117,118 and type D personality124 (which combine high negative affect with social inhibition) 125…”

“…Extraversion in FMS is associated with lower levels of pain, anxiety, and depression, and better mental health, thereby constituting a protective influence against FMS 45. In general, the presence of personality disorders and negative personality traits in FMS is associated with poorer results after pain treatment,128,129 a worsening of the functional status, higher health care demands (particularly in terms of increased number of medical visits), and greater occupational and medical costs 118,130…”

Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review

“…In three studies [ 35 , 36 , 39 ], participants were selected from previously used databases. Ten studies clearly used the ACR criteria to select participants with FM; in one study the participants were described as people who meet the ACR criteria, without other specifications [ 37 ], 7 referring to ACR criteria of 1990 [ 2 , 3 , 6 , 23 , 25 , 29 , 39 ] and only 3 used the 2010 criteria [ 28 , 38 , 30 ].…”

“…Regarding Aspects of Personality The examined studies focused on various aspects of personality associated with FM and highlighted different roles for these aspects compared to FM. Five articles used the term “personality traits” to identify specific psychopathological elements in FM patients, pointing out the role of personality disorders, anxiety, depression as characteristics of a subgroup of patients [ 35 - 37 , 40 , 41 ]. Other studies examined some specific personality traits such as alexithymia, type D personality, emotional regulation, neuropsychological aspects and dysfunctional beliefs, and used a comprehensive model of personality such as that of Eysenck, Cloninger or the big-five model.…”