Saturday, July 13, 2024

Psychological Factors Outweigh Pain Intensity in Shaping Functional Outcomes for Fibromyalgia Patients

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Fibromyalgia (FM), a condition marked by chronic widespread pain, often disrupts multiple facets of life, including personal, social, and professional realms. Noteworthy within this landscape are psychological elements such as catastrophizing and self-efficacy, which profoundly affect the management of chronic pain. This study delves into how these psychological factors influence the functional outcomes of FM patients.

Study Methodology

The research involved 91 Italian FM patients who completed an online questionnaire. Pain was assessed using the Numerical Rating Scale (NRS) and the Brief Pain Inventory (BPI), while psychological traits were evaluated using the Pain Self-Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS). Health-related quality of life was measured with the 12-item Short Form Survey (SF-12). Multiple regression models were employed to understand the predictive power of these scales on the BPI-Interference subscale and the physical and mental components of the SF-12.

Key Findings

The study’s results were telling. Both PCS and PSEQ were significant predictors of BPI-Interference, with PCS showing a positive relationship (β=0.29; p=0.001) and PSEQ a negative one (β=-0.36; p<0.001). For the SF-12-Physical score, NRS and PSEQ emerged as significant predictors (NRS: β=-0.32; p<0.001; PSEQ: β=0.50; p<0.001). Interestingly, PCS was the only significant predictor for the SF-12-Mental scores (β=-0.53; p<0.001).

The findings underscore the importance of psychological factors over pain intensity in determining functional outcomes for FM patients. This has crucial implications for market access strategies, as treatments focusing on psychological support could gain favor in healthcare settings.

Implications for Market Access

The study suggests several inferences relevant to market access for FM treatments:

  • Psychological interventions may be vital in treatment plans, potentially opening new markets for mental health services.
  • Pharmaceutical and therapeutic solutions that enhance self-efficacy might see increased demand.
  • Healthcare providers might prioritize integrated care approaches, combining pain management with psychological support.

In conclusion, psychological variables like catastrophizing and self-efficacy are pivotal in shaping the daily functioning, physical health, and mental health of FM patients. These findings advocate for a more holistic approach to FM treatment, emphasizing psychological support as much as pain management.

Original Article:

Clin Exp Rheumatol. 2024 Jun;42(6):1224-1229. doi: 10.55563/clinexprheumatol/9qrqel. Epub 2024 Jul 4.


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OBJECTIVES: Fibromyalgia (FM) is characterised by chronic widespread pain, often associated with fatigue, sleep disturbance, cognitive and mood impairment. Pain is a complex and multidimensional experience that significantly impacts personal, social, and professional functioning. Psychological factors related to chronic pain include catastrophising and self-efficacy in managing the painful condition. Therefore, this study explores the influence of chronic pain and related psychological factors on functional outcomes in FM patients.

METHODS: In this study, 91 Italian patients with FM were assessed using an online questionnaire. The questionnaire included instruments to assess pain, such as the Numerical Rating Scale (NRS) and the Brief Pain Inventory (BPI), psychological characteristics, such as the Pain Self-Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS), and health-related quality of life with the 12-item Short Form Survey (SF-12). Multiple regression models were run, using the Interference subscale of the BPI and the physical and mental components of the SF-12 as outcomes, and the NRS, PCS and PSEQ scales as predictors.

RESULTS: Our analysis revealed that in our model, both PCS and PSEQ were significant predictors of BPI-Interference (PCS: β=0.29; p=0.001; PSEQ: β=-0.36; p<0.001); NRS and PSEQ significantly predicted SF-12-Physical score (NRS: β=-0.32; p=<0.001; PSEQ: β=.50; p<0.001); PCS was found to be the only significant predictor of SF-12-Mental scores (β=-0.53; p<0.001).

CONCLUSIONS: Our results suggested that psychological variables such as catastrophic thinking and self-efficacy play a significant role in determining daily functioning and physical and mental health status in FM patients, showing greater influence than pain intensity.

PMID:38966941 | DOI:10.55563/clinexprheumatol/9qrqel

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