Does the Rural Environment Influence Symptomatology and Optimize the Effectiveness of Disease Acceptance? A Study Among Women With Fibromyalgia

Geographical disparities in fibromyalgia severity: An Italian study

BACKGROUND

Geographic origin may represent a variable capable of influencing health status. This study aims to investigate the presence of differences of disease severity in Italian patients with fibromyalgia from different macro-regions.

METHODS

This retrospective, cross-sectional study involved patients included in the Italian Fibromyalgia Registry. Three geographical macro-regions were identified, comprising patients from Northern Italy, Central Italy and Southern Italy. Clinical differences (evaluated through PolySymptomatic Distress Scale [PSD], revised Fibromyalgia Impact Questionnaire [FIQR] and modified Fibromyalgia Assessment Status [FASmod]) among the geographical macro-regions were studied using one-way analysis of variance (ANOVA) and the Scheffé's test.

RESULTS

A total of 6095 patients (5719 females and 376 males) were included, with 1957 from Northern Italy, 2979 from Central Italy and 1159 from Southern Italy. All studied clinical indices showed a trend indicative of greater disease severity in Southern Italy, followed by Northern Italy and then Central Italy (mean values for PSD: 19.97 ± 6.20 in Northern Italy, 18.61 ± 7.12 in Central Italy, 23.01 ± 5.66 in Souther Italy). These differences were statistically significant for the overall scores of all studied indices, evaluated with ANOVA (all p < 0.001) and in the head to head comparisons, evaluted with Scheffé's test.

CONCLUSIONS

Geographic background is significantly associated with variations in the severity of fibromyalgia in Italian patients.

SIGNIFICANCE STATEMENT

This is the first study to demonstrate geographical origin-dependent intra-national differences in the severity of fibromyalgia. The results confirm the necessity of considering fibromyalgia within the context of the biopsychosocial model and of implementing healthcare policies targeted towards the most underserved regions.

Extended Follow-Up and Analysis of Non-secretory IgG-Type Multiple Myeloma in a Patient With Fibromyalgia: A Case Report

Fibromyalgia (FM) presents a diagnostic challenge due to its complex symptoms and lack of definitive tests. This study discusses a 54-year-old female initially diagnosed with FM, characterized by widespread pain, fatigue, and tender points. Despite treatment, she developed elevated C-reactive protein (CRP) and anemia after two years, leading to further investigations. These tests revealed non-secretory multiple myeloma, underscoring the importance of vigilant monitoring in FM patients. This case highlights the need for regular CRP measurements and thorough follow-up to detect underlying conditions. Early detection and appropriate intervention are crucial in managing FM and improving patient outcomes.

The paradox of wellbeing: what happens among women with fibromyalgia? The effect of cognitive fusion

OBJECTIVE

Our study examined the 'paradox of wellbeing' among women with fibromyalgia and the role of cognitive fusion on wellbeing in relation to age.

METHODS

A total of 228 women diagnosed with fibromyalgia according to the American College of Rheumatology criteria were included. In order to explore the conditional effects of age in the moderation analyzes, as recommended in the PROCESS Macro, the 16th, 50th, and 84th percentiles were calculated. These percentiles define three age groups that we will call younger (from 30 to 53 years), middle-aged (from 54 to 60 years) and older women (from 61 to 78 years).

RESULTS

We found a 'paradox of wellbeing' among fibromyalgia patients which has not yet been reported: the older the patients, the higher scores on hedonic (positive affect) and eudaimonic (activities engagement) wellbeing. A moderation effect of age was found in the relationship between cognitive fusion and wellbeing (cognitive fusion showed negative associations with positive affect and activities engagement but not among older patients).

CONCLUSION

Our study underscores the need of personalized interventions for fibromyalgia patients to improve their wellbeing. Especially in younger and middle-aged patients, it would be of interest interventions in cognitive defusion through Acceptance and Commitment Therapy (ACT).

Do Cognitive Abilities Influence Physical and Mental Fatigue in Patients with Chronic Pain after Walking According to a Clinical Guideline for Physical Exercise?

The objective of this study is to explore the mediator role of cognitive fusion and chronic pain acceptance on the effects that the walking pattern, following an established clinical guideline for physical exercise, can have on fatigue (physical and mental) in patients with chronic pain. The sample consisted of a total of 231 women with fibromyalgia with a mean age of 56.91 years (Standard Deviation SD = 9.58 years, range 30−78 years). The results show a significant indirect effect of the walking pattern on both physical and mental fatigue through cognitive fusion and chronic pain acceptance. Specifically, walking predicted less cognitive fusion, which predicted greater chronic pain acceptance, which, in turn, predicted less mental and physical fatigue (Beta-B- = −0.04, Standard Error SE = 0.02, 95% Confidence Interval 95% CI = [−0.09, −0.02]; B = −0.09, SE = 0.05, 95% CI = [−0.22, −0,15], respectively). It can be concluded that the walking pattern is linked to both physical and mental fatigue through cognitive defusion and chronic pain acceptance. These cognitive abilities would allow fibromyalgia patients to perceive an improvement in both physical and mental fatigue by carrying out the walking pattern. Emphasizing the training of cognitive defusion and pain acceptance would improve the adherence of these patients to walking.