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Doreste A, Pujol J, Penelo E, Pérez V, Blanco-Hinojo L, Martínez-Vilavella G, Pardina-Torner H, Ojeda F, Monfort J, Deus J. Exploring the psychopathological profile of fibromyalgia: insights from the personality assessment inventory and its association with disease impact. Front Psychol 2024; 15:1418644. [PMID: 39328814 PMCID: PMC11424512 DOI: 10.3389/fpsyg.2024.1418644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/27/2024] [Indexed: 09/28/2024] Open
Abstract
Background Fibromyalgia (FM) is a complex rheumatic disorder characterized by chronic nociplastic pain and central sensitization. Psychopathological conditions can influence FM symptoms, which worsen their condition. However, not all patients with FM have psychopathological disorders, indicating a heterogeneous population. Objective To investigate the psychopathological profile and personality disorders in patients with FM and its relationship impact on this disease. Methods An observational and cross-sectional comparative study was conducted with a sample of 90 women, mean age 48.7 years (SD = 8.12), from Hospital del Mar, Barcelona. The Personality Assessment Inventory (PAI) and the Fibromyalgia Impact Questionnaire (FIQ) were used for assessment. Results FM patients predominantly exhibited psychopathological profiles resembling affective disorders (37.7%) and Cluster C personality disorders (58.8%). The severity of FM's impact was related to affective disorder symptoms, hypervigilance, derealization, somatization, and Cluster B personality disorder (emotional instability). Different rheumatic symptoms correlated with specific psychopathological patterns. Increased somatic symptoms on the FIQ were related to an unstable and dependent personality, while heightened emotional symptoms on the FIQ were associated with avoidance, borderline traits, and passive-aggressive reactions. Conclusion Recognizing psychopathological aspects is crucial for managing FM. The PAI is a valuable tool for establishing its psychopathological multidimensional profile, which predominantly shows an affective spectrum conditions and comorbid Cluster C personality disorder, exacerbating the disease's impact.
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Affiliation(s)
- Andrea Doreste
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G21), Barcelona, Spain
| | - Eva Penelo
- Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Barcelona, Spain
| | - Víctor Pérez
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G21), Barcelona, Spain
- Neurociences Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G21), Barcelona, Spain
| | | | - Helena Pardina-Torner
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute–IDIBELL, Barcelona, Spain
| | - Fabiola Ojeda
- Department of Rheumatology, Hospital del Mar, Barcelona, Spain
| | - Jordi Monfort
- Department of Rheumatology, Hospital del Mar, Barcelona, Spain
| | - Joan Deus
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
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LoBrutto LR, Keeley JW, Dautovich ND. Applying the Somatic Symptom Disorder Diagnosis to Individuals with Fibromyalgia: Strengths and Limitations. J Clin Psychol Med Settings 2024; 31:607-613. [PMID: 38400952 PMCID: PMC11333553 DOI: 10.1007/s10880-024-10005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/26/2024]
Abstract
Amidst broad changes to the somatic disorder diagnoses, DSM-IV pain disorder was absorbed into DSM-5's somatic symptom disorder (SSD) as a specifier. However, clinical research testing of its use for the chronic pain population has been limited and its utility remains inconclusive. Using the exemplar of fibromyalgia, this article evaluates the validity, reliability, clinical utility, and acceptability of the SSD pain specifier. The diagnosis appears to have moderate validity but low specificity for the fibromyalgia population. The pain specifier has neither undergone sufficient field testing nor been evaluated for use by medical providers, with available data suggesting low reliability. Further research is needed to establish clinical utility via assessment of differential treatment outcomes. Concerns about social, legal, and economic consequences of classifying pain patients with a mental health diagnosis are outstanding. The current SSD criteria should be used with caution among the fibromyalgia patient population until its application for chronic pain has been further researched.
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Affiliation(s)
- Lara R LoBrutto
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, VA, 23284, USA.
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, VA, 23284, USA
| | - Natalie D Dautovich
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, VA, 23284, USA
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Romanov DV, Nasonova TI, Isaikin AI, Filileeva OV, Sheyanov AM, Iuzbashian PG, Voronova EI, Parfenov VA. Personality Disorders and Traits of ABC Clusters in Fibromyalgia in a Neurological Setting. Biomedicines 2023; 11:3162. [PMID: 38137383 PMCID: PMC10740797 DOI: 10.3390/biomedicines11123162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Evidence suggests that there is substantial comorbidity between fibromyalgia and Axis II pathology (i.e., personality disorders-PDs). The aim of the current study was to find out the exact cluster (A, B, C) of PDs or traits that are more prominent in FM and may be predictors of FM diagnosis. METHODS Data from 86 subjects (53 with FM and 33 controls without FM) were analyzed in an observational, cross-sectional, comparative study in a neurological setting. The assessment of categorical PDs and traits was performed independently with the Structured Clinical Interview for Personality Disorders (SCID-II). Binary logistic regression was used to determine FM predictors among PD traits. RESULTS Compared with controls, FM patients had a higher rate of PD diagnoses (56.7 vs. 18.2%, p < 0.001). However, the rate was significantly higher only for borderline PD diagnosis (28.3% vs. 6.1% p < 0.05). The binary logistic regression analysis showed that schizotypal and schizoid (cluster A), borderline (cluster B), and dependent (cluster C) personality traits may be significant predictors of fibromyalgia (Nagelkerke R2 = 0.415). CONCLUSIONS Our results may reflect the association of FM with personality traits of all three PD clusters: A (eccentric), B (dramatic), and C (anxious). However, the most consistent evidence seems to be for borderline PD.
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Affiliation(s)
- Dmitry V. Romanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (O.V.F.); (A.M.S.); (P.G.I.); (E.I.V.)
- Mental Health Research Center, 115522 Moscow, Russia
- International Institute of Psychosomatic Health, 127550 Moscow, Russia
| | - Tatiana I. Nasonova
- Department of Nervous Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (T.I.N.); (A.I.I.); (V.A.P.)
| | - Aleksey I. Isaikin
- Department of Nervous Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (T.I.N.); (A.I.I.); (V.A.P.)
| | - Olga V. Filileeva
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (O.V.F.); (A.M.S.); (P.G.I.); (E.I.V.)
- International Institute of Psychosomatic Health, 127550 Moscow, Russia
| | - Andrey M. Sheyanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (O.V.F.); (A.M.S.); (P.G.I.); (E.I.V.)
| | - Polina G. Iuzbashian
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (O.V.F.); (A.M.S.); (P.G.I.); (E.I.V.)
| | - Evgenia I. Voronova
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (O.V.F.); (A.M.S.); (P.G.I.); (E.I.V.)
- Mental Health Research Center, 115522 Moscow, Russia
| | - Vladimir A. Parfenov
- Department of Nervous Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (T.I.N.); (A.I.I.); (V.A.P.)
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