Fibromyalgia Therapy Should Include Mental Health, Too, Study Concludes

Fibromyalgia Therapy Should Include Mental Health, Too, Study Concludes

Physical, psychological, and social factors affect fibromyalgia patients’ health-related quality of life, according to a study that used an advanced statistical model to examine the interplay of the factors.

Patients with better physical capabilities and the confidence they can control situations related to their disease have better physical quality of life scores. Meanwhile, less physical capability, depression and anxiety impact their mental wellbeing.

The study, “Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach,  also noted that better mental-health treatment can improve patients’ mental as well as physical quality of life. The research was reported in the journal PLOS ONE,

While many studies have examined quality of life among fibromyalgia patients, researchers at the Chonnam National University Hospital and Medical School in Korea noted that most of the research has examined the influence of one or a few factors at a time.

Quality of life in fibromyalgia patients is worse than in patients with other chronic diseases, including rheumatoid arthritis and chronic obstructive pulmonary disease (COPD), studies have shown.

Pain, depression, anxiety, lack of social support, and lack of self-efficacy — patients’ confidence that they can control situations that could influence the impact of their disease — all contribute to a lower sense of wellbeing, research has indicated. In studies addressing several factors, the choice of statistical method has prevented researchers from seeing the full picture, the authors argued.

The team used a method that can take into account several contributing factors at a time, as well as the relationships between them.

They assessed health-related quality of life, physical disability, depression, anxiety, social support, and self-efficacy in 336 patients, 89.6 percent of whom were women.

Their quality of life tool they used was able to distinguish between physical and mental factors impacting the patients. Poor fibromyalgia-related health status and low confidence in one’s ability to control the impact of the disease was linked to poor physical quality of life. But, importantly, depression and anxiety also impacted physical wellbeing.

On the other hand, mental quality of life was affected by all the factors that researchers investigated, including physical quality of life.

The study showed that the factors interacted with each other in a complex way. Depression was linked to all other factors, as was anxiety. Also, social support was linked to all other factors except the physical parameter of wellbeing.

“In conclusion, HRQOL [health-related quality of life] in FM patients was affected by physical, social, and psychological variables in our structural equation model. Higher physical function and higher self-efficacy may all improve the physical component of HRQOL, and better physical function and lower levels of depression and anxiety may directly improve the mental component of HRQOL.” the team concluded.

The findings underscore that fibromyalgia care needs to take into account more than just the obvious pain-related symptoms. Medical treatments, as well as non-medical interventions that improve mental health, may help improve physical measures of the disease as well.

7 comments

  1. Denise Bault says:

    DUH! Of course it affects us more than those with RA or COPD. Those are recognized illnesses…fibromyalgia is barely known. About the only good thing Big Pharma has done is advertise their 3 meds – which help a relative few – and that brings awareness at least on a superficial level. I have found one of the hardest parts of this illness is lack of social support. It’s no wonder we are depressed and anxious! Once again, here is an article that tells us what we already know…but fails to tell us anything about what the “non-medical interventions that improve mental health” are. Maybe it is being saved for another article?

    • Magdalena Kegel says:

      Dear Denise,
      Exercise and cognitive behavior therapy are the two non-pharmacological interventions with the strongest evidence supporting their effectivity.

      • Sandra says:

        One thing to consider about these ‘Studies’ that always point to Exercise as being the end all….who were the patients in the study and whose study is it – drug company? Free-standing research facility? Docs? What? Reason I ask is I have several times (over 20+ yrs) considered being in a study but guess what…I’m Too Darned Sick to get there and go through all the commotion and be able to make it through the entire 3 months or whatever so….you have to wonder just how sick, how bad of Fibro these people actually have if they can get there and do all that along with their regular lives so, yeah, maybe exercise does help those people. But the rest of us? My walk to the mailbox has more repercussions than I can deal with as it is. There is no building up. Just something to consider…how bad off really are those patients in the study.

      • Griselda says:

        Dear Magdalena, I have been through cognitive behavioral, therapy, I have had years of mental therapy, I exercise when I can and today I’m having one of my worse days

        • Magdalena Kegel says:

          Dear Griselda,
          I am very sorry to hear that. As with all types of treatments and diseases, some people are not helped by an approach that benefits others. Research is all the time ongoing to figure out why, and to find other approaches that might help.

  2. I am really glad to see this article. I have fibromyalgia myself and my mental health was severely effected. I had to work very hard on improving my mental health and the extreme depression, anxiety and at times suicidal thoughts (although I wouldn’t do this) I had. Plus if you’re mental health is in a good place then you can deal with anything this condition throws at you with your physical health.

  3. Em says:

    Mental health support would be a positive thing-I am still being harassed and stalked by a LMHC that received a 99 year suspension and I did not even file the charges. Like I could enter this arena again.

    I will deal w/ things w/ poetry and painting-so much safer.

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