• Pain Pract · Mar 2020

    Patients with fibromyalgia reporting severe pain but low impact of the syndrome: clinical and pain-related cognitive features.

    • Natalia Angarita-Osorio, Adrián Pérez-Aranda, Albert Feliu-Soler, Laura Andrés-Rodríguez, Xavier Borràs, Carlos Suso-Ribera, Mahmoud Slim, Paola Herrera-Mercadal, Rita Fernández-Vergel, Mª Elena Blanco, and Juan V Luciano.
    • Group of Psychological Research in Fibromyalgia & Chronic Pain (AGORA), Fundació Sant Joan de Déu, Esplugues de Llobregat, Spain.
    • Pain Pract. 2020 Mar 1; 20 (3): 255-261.

    BackgroundFibromyalgia (FM) is a prevalent and highly disabling chronic pain syndrome. However, differences among patients regarding how pain impacts on daily life are remarkable. The main aim of this study was to identify clinical and pain-related cognitive variables characterizing patients reporting high adaptability despite experiencing severe chronic pain.MethodsTwo hundred and eighty-three Spanish patients with FM with high levels of pain were classified into 2 groups: (1) those reporting low impact of the syndrome, and (2) those with moderate-to-high impact. Perceived stress, anxiety, and depressive symptoms along with pain catastrophizing, psychological inflexibility, and perceived control over pain were evaluated. Differences in sociodemographics, years with FM, past/current major depressive disorder comorbidity, and health-related economic costs (ie, medications, use of medical services, lost productivity due to sick leave) were also assessed. Stepwise logistic regression analyses predicting group membership from clinical variables and pain-related cognitive processes as predictors were performed.ResultsLower stress, anxiety, and depressive symptoms, along with reduced pain catastrophism, psychological inflexibility, and perceived control over pain, were found in the low-impact group. Significant predictors of group membership (low-impact vs. moderate-to-high impact) in regression analyses were "cognitive fusion" (psychological inflexibility), "helplessness" (pain catastrophizing), and depressive symptomatology, together with pain intensity and other FM symptoms.ConclusionsThe present study provides further evidence on resilience resources in chronic pain by identifying some variables (ie, reduced depressive symptomatology, pain catastrophizing, and psychological inflexibility) differentially characterizing a profile of patients with FM who are especially able to adapt to high levels of pain.© 2019 World Institute of Pain.

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