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Psychological impact of fibromyalgia: current perspectives.
Galvez-Sánchez, Carmen M, Duschek, Stefan, Reyes Del Paso, Gustavo A · Psychology research and behavior management · 2019 · DOI
Quick Summary
Fibromyalgia is a chronic pain condition that often comes with fatigue, sleep problems, and difficulty concentrating. This review found that people with fibromyalgia frequently experience depression, anxiety, and other mental health challenges, and these psychological symptoms can make the physical illness worse. The study suggests that combining talk therapy or other psychological support with medication may help patients feel better and improve their quality of life.
Why It Matters
This work is important for ME/CFS patients because fibromyalgia shares substantial symptom overlap with ME/CFS (fatigue, cognitive dysfunction, sleep disturbance, comorbidity patterns) and similar psychological comorbidity profiles. Understanding the bidirectional relationship between psychological factors and physical symptoms in fibromyalgia may illuminate mechanisms relevant to ME/CFS and support development of integrated, patient-centered care approaches.
Observed Findings
High prevalence of psychiatric comorbidities in FMS, particularly depression, anxiety, borderline personality disorder, OCD, and PTSD
Elevated levels of negative affect, neuroticism, perfectionism, stress, anger, and alexithymia in FMS patients
Specific temperament and character patterns: high harm avoidance, high self-transcendence, low cooperativeness, and low self-directedness
Negative self-image, poor body image perception, low self-esteem, and reduced perceived self-efficacy
Significant impairment in physical, psychological, social, cognitive, occupational, relational, and daily functioning domains, with some patients reporting suicidal ideation or attempts
Inferred Conclusions
Psychiatric and psychological factors substantially contribute to the clinical profile and functional impairment observed in FMS patients
Psychological interventions should be integrated with pharmacological treatment to improve symptom outcomes and quality of life
Negative illness perception and stigma associated with the 'invisible' nature of FMS impede adaptation and may exacerbate psychological distress
Remaining Questions
What is the temporal relationship between psychiatric symptoms and fibromyalgia onset—do psychiatric conditions precede, follow, or emerge concurrently with FMS?
What This Study Does Not Prove
This study does not prove that psychological factors cause fibromyalgia—rather, it documents their frequent co-occurrence and association with worse outcomes. It does not establish which psychiatric symptoms precede the illness, which emerge as consequences, or what the underlying biological mechanisms are. The review does not differentiate between primary psychiatric comorbidity and secondary psychological distress resulting from chronic illness.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →