Statin Therapy and Symptom Burden in Patients With Fibromyalgia: A Prospective Questionnaire Study

Objective

To evaluate the association between statin use and symptom severity, tender point count, fatigue, cognition, mood, and sleep issues in patients with fibromyalgia (FM).

Methods

Between May 2012 and November 2013, 668 patients with FM were surveyed. Patients were stratified into statin users and statin nonusers. Primary outcome was FM symptom severity (FIQ-R questionnaire) and tender point count. Secondary outcomes included fatigue (MFI-20), cognitive dysfunction (MASQ), anxiety (GAD-7), depression (PHQ-9), and sleep issues (SPI-II). Regression analysis assessed for differences in these clinical outcomes between statin users and statin nonusers and adjusted for age, sex, body mass index, ethnicity, tobacco use, opioid use, and neuropathic medication use.

Results

Of the FM patients, 79 (11.8%) were statin users, whereas 589 (88.2%) reported no current statin use. Compared with the control cohort, statin users were older (55.0±11.3 years vs 46.2±12.9 years; P<.001) and had a higher body mass index (33.0±7.0 kg/m² vs 29.8±7.7 kg/m²; P=.001). Adjusted linear regression revealed no association between statin use and symptom severity (total FIQ-R scores, 57.7±18.3 vs 59.0±18.1; adjusted β coefficient, −0.4; 95% CI, −4.8 to 4.1; P=.871). There was also no association between statin use and tender point count (14.8±4.1 vs 14.5±4.2; adjusted β coefficient, 0.2; 95% CI, −0.8 to 1.2; P=.732). Secondary outcome analysis revealed no difference between statin users and statin nonusers in metrics measuring fatigue, cognition, anxiety, depression, and sleep problems.

Conclusion

Administration of statin therapy for at least 1 month is not a risk factor for worse symptom burden in patients with FM. Statin therapy should be offered to dyslipidemic FM patients with an appropriate medical indication to optimize their cardiovascular health.

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

BACKGROUND

The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020.

METHODS

Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT.

RESULTS

Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated.

CONCLUSION

ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.