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Gianlorenço AC, Costa V, Fabris-Moraes W, Menacho M, Alves LG, Martinez-Magallanes D, Fregni F. Cluster analysis in fibromyalgia: a systematic review. Rheumatol Int 2024; 44:2389-2402. [PMID: 38748219 DOI: 10.1007/s00296-024-05616-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/03/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND The multifaceted nature of Fibromyalgia syndrome (FM) symptoms has been explored through clusters analysis. OBJECTIVE To synthesize the cluster research on FM (variables, methods, patient subgroups, and evaluation metrics). METHODS We performed a systematic review following the PRISMA recommendations. Independent searches were performed on PubMed, Embase, Web of Science, and Cochrane Central, employing the terms "fibromyalgia" and "cluster analysis". We included studies dated to January 2024, using the cluster analysis to assess any physical, psychological, clinical, or biomedical variables in FM subjects, and descriptively synthesized the studies in terms of design, cluster method, and resulting patient profiles. RESULTS We included 39 studies. Most with a cross-sectional design aiming to classify subsets based on the severity, adjustment, symptomatic manifestations, psychological profiles, and response to treatment, based on demographic and clinical variables. Two to four different profiles were found according to the levels of severity and adjustment to FMS. According to symptom manifestation, two to three clusters described the predominance of pain versus fatigue, and thermal pain sensitivity (less versus more sensitive). Other clusters revealed profiles of personality (pathological versus non-pathological) and psychological vulnerability (suicidal ideation). Additionally, studies identified different responses to treatment (pharmacological and multimodal). CONCLUSION Several profiles exist within FMS population, which point out to the need for specific treatment options given the different profiles and an efficient allocation of healthcare resources. We notice a need towards more objective measures, and the validation of the cluster results. Further research might investigate some of the assumptions of these findings, which are further discussed in this paper.
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Affiliation(s)
- Anna Carolyna Gianlorenço
- Neuroscience and Neurological Rehabilitation Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA
| | - Valton Costa
- Neuroscience and Neurological Rehabilitation Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA
| | - Walter Fabris-Moraes
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA
| | - Maryela Menacho
- Neuroscience and Neurological Rehabilitation Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA
| | - Luana Gola Alves
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA
| | - Daniela Martinez-Magallanes
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA
| | - Felipe Fregni
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA, USA.
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Therapeutic Patient Education for Fibromyalgia during Spa Therapy: The FiETT Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084613. [PMID: 35457480 PMCID: PMC9030628 DOI: 10.3390/ijerph19084613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 01/13/2023]
Abstract
Spa therapy is known to improve quality of life and diminish pain. We assessed the efficacy (Fibromyalgia Impact Questionnaire-FIQ) and safety at 6 months of a fibromyalgia-specific therapeutic patient education (TPE) program added to fibromyalgia-specific standardized spa therapy (SST), compared to SST alone, in a controlled randomized trial. We enrolled 157 patients, mostly women, attending spa centers in Southwest France in 2015–2016, and randomized them to SST + TPE (79) or SST (78). The intention-to-treat with “missing as failure” analysis showed a tendency toward a higher, though non-significant, benefit with TPE than without for FIQ (−9 vs. −3; p = 0.053) or pain intensity (−0.9 vs. −1.1; p = 0.58). In addition, pain relief (+3.2 vs. +4.3; p = 0.03) and fatigue (−1.6 vs. −3.7; p = 0.02) were significantly improved, and 87% patients in the SST + TPE arm still regularly practiced the physical exercises taught to them at 6 months. We suspect significant and lasting improvement from spa therapy, as well as our already well-informed and well-managed participants, to have prevented the demonstration of a significant benefit of TPE on FIQ.
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Velasco L, López-Gómez I, Gutiérrez L, Écija C, Catalá P, Peñacoba C. Exploring the Preference for Fatigue-avoidance Goals as a Mediator Between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women With Fibromyalgia. Clin J Pain 2021; 38:182-188. [PMID: 34928869 DOI: 10.1097/ajp.0000000000001010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Along with the symptoms of pain and fatigue, pain catastrophizing and avoidance behaviors are highly prevalent and associated with functional impairment in fibromyalgia (FM) patients. Although pain and fatigue affect patients' quality of life, research has been exclusively focused on how pain affects physical activity and exercise. The aim of this study was to analyze the role of pain catastrophizing and preference for fatigue-avoidance goals in walking behavior and functional impairment in women with FM. MATERIALS AND METHODS In this cross-sectional study the sample was composed of 76 participants aged 18 years and older (mean age=55.05, SD=7.70). The study evaluated pain catastrophizing, preference for fatigue-avoidance goals, functional impairment, and walking behavior along with sociodemographic variables and clinical data. RESULTS Pain catastrophizing was associated with preference for fatigue-avoidance goals and this preference was associated with greater functional impairment and less distance walked. Path analysis supported the mediating role of preference for fatigue-avoidance goals in the relationship between pain catastrophizing and walking behavior and between pain catastrophizing and functional impairment. Furthermore, pain catastrophizing predicted greater preference for fatigue-avoidance goals which predicted more problems in functioning and less distance walked. DISCUSSION The present study may help clarify the connection between the factors that stop individuals with FM from implementing beneficial behaviors such as walking, and thus, allowing for the design of psychological interventions that seek to maintain physical functioning despite experiencing fatigue.
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Affiliation(s)
- Lilian Velasco
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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Vera Cruz G, Bucourt E, Réveillère C, Martaillé V, Joncker-Vannier I, Goupille P, Mulleman D, Courtois R. Machine learning reveals the most important psychological and social variables predicting the differential diagnosis of rheumatic and musculoskeletal diseases. Rheumatol Int 2021; 42:1053-1062. [PMID: 34125252 DOI: 10.1007/s00296-021-04916-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/05/2021] [Indexed: 11/28/2022]
Abstract
There is an ongoing debate about the importance and the extent to which psychological and psychopathological factors, adverse childhood experiences, and socio-demographic characteristics are associated with the development of certain types of rheumatic disease. With the aim of contributing to knowledge on the subject, the present study uses machine learning modeling to determine the importance of 20 psychological and social variables in predicting two classes of rheumatic disease: inflammatory rheumatic and musculoskeletal diseases (RMD) (rheumatoid arthritis = RA, spondyloarthritis = SA, and Sjögren's syndrome = SS) versus non-inflammatory RMD, namely fibromyalgia = FM). A total of 165 French women with FM, RA, SA, and SS completed an inventory of personality traits, a psychopathology diagnosis questionnaire, and a fatigue/pain questionnaire. They also answered questions about adverse childhood experiences and socio-demographic characteristics. Random forest and logistic regression machine learning algorithms were used for data analysis. The main findings suggest that mistreatment during childhood ((MDA = 10.22), the agreeableness personality trait (MDA = 3.39), and somatic disorder (MDA = 3.25) are the main psychological and social predictors of the type of rheumatic disease diagnosed. The first two predictors (OR = 18.92 and OR = 6.11) are also more strongly associated with FM than with RA-SA-SS. Overall, adverse childhood experiences seem relatively more important than personality traits, psychopathological or demographic variables. The results of this study suggest that traumatic childhood experiences may lead to psychopathological disorders in adulthood, which in turn might underlie, at least in part, the development of FM. Since there are no imaging or biological markers of FM, the present findings contribute to the scientific literature offering information to help patients with FM understand their pathology. They may also provide physicians with more diagnostic information.
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Affiliation(s)
- Germano Vera Cruz
- QualiPsy, EE 1901, University of Tours, 37000, Tours, France. .,Centre Val de Loire Resource Center for Professionals Working With Sex Offenders, Tours University Hospital, 37000, Tours, France. .,MSHS-Poitiers, 5 rue Théodore Lefebvre, 86073, Poitiers, France.
| | - Emilie Bucourt
- QualiPsy, EE 1901, University of Tours, 37000, Tours, France
| | | | - Virginie Martaillé
- Regional Hospital of Orléans, Rheumatology department, 45000, Orléans, France
| | | | - Philippe Goupille
- University of Tours, Rheumatology department, 37000, Tours, France.,CIC 1415, University Hospital of Tours, 37000, Tours, France
| | - Denis Mulleman
- University of Tours, Rheumatology department, 37000, Tours, France.,CIC 1415, University Hospital of Tours, 37000, Tours, France
| | - Robert Courtois
- QualiPsy, EE 1901, University of Tours, 37000, Tours, France.,Centre Val de Loire Resource Center for Professionals Working With Sex Offenders, Tours University Hospital, 37000, Tours, France
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Sheila B, Octavio LR, Patricia C, Dolores B, Lilian V, Cecilia P. Perfectionism and Pain Intensity in Women with Fibromyalgia: Its Influence on Activity Avoidance from The Contextual Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8442. [PMID: 33202698 PMCID: PMC7698249 DOI: 10.3390/ijerph17228442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/25/2022]
Abstract
Given the scarcity of studies regarding perfectionism from a contextual perspective, this study aims to analyze its role in the relationship between pain and activity avoidance and its differential effect among patients with different fibromyalgia severity. A cross-sectional study with 228 women with fibromyalgia classified into two disease severity groups (low/moderate vs. high) was carried out. Moderation analyses were conducted; perfectionism was used as moderator, pain (in high and low pain situations) as independent variable, and activity avoidance as the outcome. Among the high disease severity group, analyses showed direct contributions of perfectionism (p < 0.001) but not of pain (p > 0.05); moderation effects were found in high pain situations (p = 0.002) (for low levels of perfectionism, a positive association was found between pain intensity and avoidance). Among the low severity group, direct effects of perfectionism (p < 0.05) and pain intensity (p = 0.04) were found (although the latter only for high pain situations); moderation effects were found in high pain situations (p = 0.018) (for high levels of perfectionism a positive and significant association was found between pain intensity and avoidance). Perfectionism has been found to be a key variable in the differential relationship between pain intensity (in high pain situations) and activity avoidance in groups with high and low disease severity.
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Affiliation(s)
- Blanco Sheila
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Luque-Reca Octavio
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Catala Patricia
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Bedmar Dolores
- Pain Unit, Hospital Universitario de Fuenlabrada, 28944 Fuenlabrada, Madrid, Spain;
| | - Velasco Lilian
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Peñacoba Cecilia
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
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Blanco S, Sanromán L, Pérez-Calvo S, Velasco L, Peñacoba C. Olfactory and cognitive functioning in patients with fibromyalgia. PSYCHOL HEALTH MED 2018; 24:530-541. [PMID: 30453770 DOI: 10.1080/13548506.2018.1549741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Fibromyalgia is a complex syndrome characterized by chronic musculoskeletal pain. Previous research has found impaired olfactory function and cognitive deficits in patients with fibromyalgia. In non-clinical population (middle-aged and elderly populations) an association has been found between olfactory function and cognitive impairment. Therefore, olfactory impairment identification could be considered as a reliable and early marker predicting the decline of cognitive function in mild cognitive impairment, Alzheimer's disease and Parkinson's disease. Nevertheless, the relationship between cognitive and olfactory functioning has not been studied in fibromyalgia patients. The aims of the study have been to analyze the cognitive and olfactory functioning and their association in a sample of women with fibromyalgia in comparison to women without a chronic pain disease. A transversal study was conducted with fibromyalgia patients (n = 146) and women without a chronic pain disease (n = 122). Data were collected using the WAIS-III (cognitive functioning) and the CCCRC test (olfactory functioning). Descriptive analysis, Student's t test and chi-square tests were conducted. There were significant differences in perceptive organization and processing speed, and in odour identification, odour threshold and total CCCRC score; the lower scores were for fibromyalgia patients. Among the fibromyalgia patients there were significant differences in the verbal scale, the manipulative scale, the total scale and processing speed between normosmic and hyposmic patients, the lowest scores were for hyposmic patients. Although previous literature has shown that self-reports by fibromyalgia patients inform about an enhanced olfactory acuity, the current study suggests that there are deficits in olfactory functioning in these patients. Also, the relationship between olfactory and cognitive functioning in fibromyalgia patients, due to the lack of previous studies, suggests a new line of research. Taken together, these results suggest that olfactory functioning could be included in a bio-psycho-social approach of fibromyalgia patients, because of the association with cognitive functioning.
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Affiliation(s)
- Sheila Blanco
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Lucía Sanromán
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Soledad Pérez-Calvo
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Lilian Velasco
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Cecilia Peñacoba
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
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Conversano C, Marchi L, Rebecca C, Carmassi C, Contena B, Bazzichi LM, Gemignani A. Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review. Clin Pract Epidemiol Ment Health 2018; 14:223-232. [PMID: 30294356 PMCID: PMC6166394 DOI: 10.2174/1745017901814010223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/10/2018] [Accepted: 07/28/2018] [Indexed: 01/25/2023]
Abstract
Introduction: Fibromyalgia (FM) is the second most common rheumatic disease with many effects on patient's quality of life. It has been described as a chronic condition characterized by widespread musculo-skeletal pain, sleep disorders and prominent fatigue. Regarding the role of personality factors in fibromyalgia, researchers have focused both on personality traits and psychopathological aspects showing inconsistent results. In particular, several studies have examined the role of alexithymia in FM patients, a trait of personality characterized by difficulty in identification, recognition and description of emotions and feelings, while others have focused on a specific type of personality, such as type D personality (distressed personality). Other studies investigated personality in FM patients referring to Cloninger’s model, a psychobiological model of personality that includes both temperamental and character dimensions of personality. Analyzing scientific literature on this subject seems well suited to provide a critical review of the latest studies and their results. Methods: The method used for this review satisfies the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). We identified PsycInfo and PubMed as databases for our research. Results: Personality is studied under many aspects and a reference model is not always present. Many studies underline high levels of alexithymia and type D personality in FM patients but when depression is controlled, these results do not differ from those of healthy controls. Conclusion: Studies that use a comprehensive model of personality present a different theoretical approach and use alternatively the Big-Five model, Eysenck’s and Cloninger’s models. The use of a comprehensive model of personality and the control of psychopathological disorders, such as anxiety and depression, seem to be very relevant for a better understanding of a specific personality profile associated with fibromyalgia.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Laura Marchi
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Ciacchini Rebecca
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | | | - Laura Maria Bazzichi
- Department of Clinical and Experimental Medicine, Rheumatologic Clinic, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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Novo R, Gonzalez B, Peres R, Aguiar P. A meta-analysis of studies with the Minnesota Multiphasic Personality Inventory in fibromyalgia patients. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.04.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bucourt E, Martaillé V, Mulleman D, Goupille P, Joncker-Vannier I, Huttenberger B, Reveillere C, Courtois R. Comparison of the Big Five personality traits in fibromyalgia and other rheumatic diseases. Joint Bone Spine 2016; 84:203-207. [PMID: 27269650 DOI: 10.1016/j.jbspin.2016.03.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 03/02/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The personality of patients with fibromyalgia is still under debate. Some studies found high neuroticism associated with low extraversion, while others found that these traits do not differ from the normal population. Personality factors intervene in the emotional regulation and modulation of pain. The aim of the study was to determine the personality traits of patients with fibromyalgia compared to other rheumatic diseases. METHODS In a multicentric study, women with fibromyalgia, rheumatoid arthritis, spondyloarthritis or Sjögren's syndrome were asked to complete the Big Five Inventory, which encompasses five main personality dimensions, namely (1) extraversion vs. introversion, (2) agreeableness vs. antagonism, (3) conscientiousness vs. impulsivity, (4) neuroticism vs. emotional stability, and (5) openness vs. closed-mindedness. Variance analysis (Student's t-test and ANOVA with post-hoc comparisons or Bonferroni correction) was performed. We also conducted hierarchical and non-hierarchical cluster analyses. RESULTS AND DISCUSSION Participants were 163 women with fibromyalgia (n=48), rheumatoid arthritis (n=46), spondyloarthritis (n=46) and Sjögren's syndrome (n=23). The mean age was 47.18years (±10.81years, range 21 to 65). Patients with fibromyalgia had higher scores on agreeableness (F(3, 159)=3.39, P<0.05), neuroticism (F(3, 159)=3.79, P<0.05) and openness (F(3, 159)=4.32, P<0.01) than those with other rheumatic diseases. This study highlights the specificity of personality in fibromyalgia. It also underlines the protective role of personality traits: in the fibromyalgia group, high neuroticism and low conscientiousness (high impulsivity) were associated with a high level of chronic pain.
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Affiliation(s)
- Emilie Bucourt
- EA 2114 « Psychologie des âges de la vie et adaptation », département de psychologie, université François-Rabelais de Tours, 3, rue des Tanneurs, BP 4103, 37041 Tours cedex 1, France
| | - Virginie Martaillé
- Service de rhumatologie, université François-Rabelais de Tours, CHRU de Tours, 37044 Tours cedex 09, France
| | - Denis Mulleman
- Service de rhumatologie, université François-Rabelais de Tours, CHRU de Tours, 37044 Tours cedex 09, France
| | - Philippe Goupille
- Service de rhumatologie, université François-Rabelais de Tours, CHRU de Tours, 37044 Tours cedex 09, France
| | - Isabelle Joncker-Vannier
- Centre d'Étude et de traitement de la douleur (CETD), CHRU de Tours, 37044 Tours cedex 09, France
| | - Brigitte Huttenberger
- Service de chirurgie maxillo-faciale, plastique de la face et stomatologie, université François-Rabelais de Tours, CHRU de Tours, 37041 Tours cedex, France
| | - Christian Reveillere
- EA 2114 « Psychologie des âges de la vie et adaptation », département de psychologie, université François-Rabelais de Tours, 3, rue des Tanneurs, BP 4103, 37041 Tours cedex 1, France
| | - Robert Courtois
- EA 2114 « Psychologie des âges de la vie et adaptation », département de psychologie, université François-Rabelais de Tours, 3, rue des Tanneurs, BP 4103, 37041 Tours cedex 1, France; Clinique psychiatrique universitaire, CHRU de Tours, 37044 Tours cedex 09, France.
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Leombruni P, Zizzi F, Miniotti M, Colonna F, Castelli L, Fusaro E, Torta R. Harm Avoidance and Self-Directedness Characterize Fibromyalgic Patients and the Symptom Severity. Front Psychol 2016; 7:579. [PMID: 27199814 PMCID: PMC4842927 DOI: 10.3389/fpsyg.2016.00579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/07/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Evidence in the literature suggests peculiar personality traits for fibromyalgic (FM) patients, and it has been suggested that personality characteristics may be involved in patients' different symptomatic events and responses to treatment. The aim of the study is to investigate the personality characteristics of Italian FM patients and to explore the possibility of clustering them considering both personality traits and clinical characteristics. DESIGN The study used a cross-sectional methodology and involved a control group. A self-assessment procedure was used for data gathering. The study included 87 female FM patients and 83 healthy females. Patients were approached and interviewed in person during a psychiatric consultation. Healthy people were recruited from general practices with previous telephone contact. MAIN OUTCOME MEASURES Participants responded to the Hospital Anxiety and Depression Scale, the Temperament and Character Inventory, the Fibromyalgia Impact Questionnaire and the Short-Form-36 Health Survey. RESULTS FM patients scored significantly different from healthy participants on the Harm avoidance (HA), Novelty seeking (NS) and Self-directedness (SD). Two clusters were identified: patients in Cluster1 (n = 37) had higher scores on HA and lower scores on RD, SD, and Cooperativeness and reported more serious fibromyalgia and more severe anxious-depressive symptomatology than did patients in Cluster2 (n = 46). CONCLUSION This study confirms the presence of certain personality traits in the FM population. In particular, high levels of HA and low levels of SD characterize a subgroup of FM patients with more severe anxious-depressive symptomatology. According to these findings, personality assessment could be useful in the diagnostic process to tailor therapeutic interventions to the personality characteristics.
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Affiliation(s)
- Paolo Leombruni
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Francesca Zizzi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Marco Miniotti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Fabrizio Colonna
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Azienda Ospedaliero-Universitaria Cittá della Salute e della Scienza di Torino Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
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