PO:29:141 | Assessing psychosomatic diagnoses and psychological distress in patients with fibromyalgia. The clinical utility of a multidisciplinary approach

Sara Ceccatelli¹, Francesca Nacci², Ginevra Fiori², Gemma Lepri², Fiammetta Cosci³, Serena Guiducci² | ¹Dipartimento di Medicina Sperimentale e Clinica; ²Divisione di Reumatologia, Dipartimento di Medicina Sperimentale e Clinica; ³Dipartimento di Scienze della Salute, Università di Firenze, Italy

Background. Fibromyalgia is a central sensitization syndrome characterized by chronic widespread musculoskeletal pain associated with fatigue, sleep disturbances, cognitive impairment, psychological difficulties, and somatic and neurovegetative symptoms. It affects approximately 2–8% of the general population, with a higher prevalence among females. It is a functional disorder, given the lack of biological markers for diagnosis. The aim of the present study was to evaluate whether a multidisciplinary assessment which includes tools to evaluate mental disorders and psychological distress in fibromyalgia might be associated with psychosomatic syndromes and whether the occurrence of psychosomatic syndromes may influence patients’ psychological distress and functioning.

Methods. We assessed 151 patients with fibromyalgia who were attending the Rheumatology Unit of the Academic Hospital Careggi in Florence, Italy. A clinical psychologist evaluated psychosomatic syndromes by administering the Revised Semi-Structured Interview for Diagnostic Criteria for Psychosomatic Research (DCPR-R-SSI). Psychological distress, psychological well-being, mental pain and perceived loneliness were evaluated via self-report questionnaires: Symptom Questionnaire (SQ), PsychoSocial Index (PSI), World Health Organization-Five Well-Being Index (WHO-5), Mental Pain Questionnaire (MPQ), and UCLA Loneliness Scale (UCLA).

Results. The sample included 143 females and 7 males, with a mean age of 54.23 ± 12.63 years. Most participants had a partner (62.7%) and were employed (58.6%). Nearly all patients (94%) presented at least one psychosomatic syndrome. Patients with three or more psychosomatic syndromes showed significantly higher levels of anxiety, somatization, depression, anger–hostility, psychological distress, abnormal illness, mental pain, and perceived loneliness (p < 0.05), along with lower levels of psychological well-being (p < 0.05).

Conclusions. Psychosomatic syndromes in patients with fibromyalgia worsen the psychological distress, impair perceived well-being and complicate the clinical picture. These findings highlight the importance of a multidisciplinary assessment that considers psychosomatic aspects to enable a comprehensive evaluation of the patients.