Andrea Doreste

Background: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, cognitive difficulties, and psychological symptoms. Patients often present distinct personality traits and psychopathological patterns associated with symptom severity. Objective: To examine psychopathological profiles in FM patients based on functional, physical–somatic, and emotional impairment domains, as well as on cumulative disease severity. Materials and Methods: A cross-sectional study was conducted with 70 women clinically diagnosed with FM at a specialized Fibromyalgia Unit. Psychological functioning was assessed using the Personality Assessment Inventory, and disease impact was measured with the Fibromyalgia Impact Questionnaire. Hierarchical cluster analyses were used to classify participants into mild and severe clusters across FIQ domains, and psychological profiles were compared. Results: Patients with severe functional impairment had more affective dysregulation (76.43 vs. 70.20, p < 0.01) and somatic complaints (85.57 vs. 79.76, p < 0.05) than those with mild impairment. The severe–physical cluster showed greater mood instability, somatization, and suicidal ideation (60.94 vs. 53.61, p < 0.05). The severe–emotional cluster had higher rates of major depression (85.71% vs. 64.28%) and persistent depressive disorder (76.19% vs. 70.61%, p < 0.05). Severe showed more emotional instability and somatization, distinguishing it from mild. Greater cumulative severity intensified depressive and somatic disorders. Discussion: Findings support FM’s biopsychosocial profile, where emotional distress may relate to psychological and physical symptoms, reinforcing the need for personalized, multidisciplinary care and comprehensive assessment.

Background: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, cognitive difficulties, and psychological symptoms. Patients often present distinct personality traits and psychopathological patterns associated with symptom severity. Objective: To examine psychopathological profiles in FM patients based on functional, physical-somatic, and emotional impairment domains, and on cumulative disease severity. Materials and Methods: A cross-sectional study was conducted with 70 women clinically diagnosed with FM at a specialized Fibromyalgia Unit. Psychological functioning was assessed using the Personality Assessment Inventory, and disease impact was measured with the Fibromyalgia Impact Questionnaire. Hierarchical cluster analyses were used to classify participants into mild and severe clusters across FIQ domains, and psychological profiles were compared. Results: Patients with severe functional impairment had more affective dysregulation (76.43vs.70.20,p<0.01) and somatic complaints (85.57vs.79.76,p<0.05) than those with mild impairment. The severe-physical cluster showed greater mood instability, somatization, and suicidal ideation (60.94vs.53.61,p<0.05). The severe-emotional cluster had higher rates of major depression (85.71%vs.64.28%) and persistent depressive disorder (76.19%vs.70.61%,p<0.05). Severe showed more emotional instability and somatization, distinguishing it from mild. Greater cumulative severity intensified depressive and somatic disorders. Discussion: Findings support FM’s biopsychosocial profile, where emotional distress relates to psychological and physical symptoms, reinforcing the need for personalized, multidisciplinary care.

Background: Fibromyalgia (FM) is a complex condition marked by increased pain sensitivity and central sensitization. Studies often explore the link between FM and depressive anxiety disorders, but few focus on dysthymia or persistent depressive disorder (PDD), which can be more disabling than major depression (MD). Objective: To identify clinical scales and subscales of the Personality Assessment Inventory (PAI) that effectively describe and differentiate the psychological profile of PDD, with or without comorbid MD, in FM patients with PDD previously dimensionally classified by the Millon Clinical Multiaxial Inventory III (MCMI-III). Method: An observational, cross-sectional study was conducted with 66 women (mean age 49.18, SD = 8.09) from Hospital del Mar. The PAI, the MCMI-III, and the Fibromyalgia Impact Questionnaire (FIQ) were used to assess the sample. Results: The PAI showed strong discriminative ability in detecting PDD, characterized by high scores in cognitive and emotional depression and low scores in identity alteration, dominance, and grandeur. High scores in cognitive, emotional, and physiological depression, identity alteration, cognitive anxiety, and suicidal ideation, along with low scores in dominance and grandeur, were needed to detect MD with PDD. Discriminant analysis could differentiate 69.6–73.9% of the PDD group and 84.6% of the PDD+MD group. Group comparisons showed that 72.2% of patients with an affective disorder by PAI were correctly classified in the MCMI-III affective disorder group, and 70% without affective disorder were correctly classified. Conclusions: The PAI effectively identifies PDD in FM patients and detects concurrent MD episodes, aiding in better prognostic and therapeutic guidance.

Background. Fibromyalgia (FM) is a complex condition marked by increased pain sensitivity and central sensitization. Studies often explore the link between FM and depressive-anxiety disorders, but few focus on dysthymia or persistent depressive disorder (PDD), which can be more disabling than major depression (MD). Objective. To identify clinical scales and subscales of the Personality Assessment Inventory (PAI) that effectively describe and differentiate the psychological profile of PDD, with or without comorbid MD, in FM patients with PDD previously dimensionally classified by the Millon Clinical Multiaxial Inventory III (MCMI-III). Method. An observational, cross-sectional study was conducted with 66 women (mean age 49.18, SD=8.09) from Hospital del Mar. The PAI, the MCMI-III, and Fibromyalgia Impact Questionnaire (FIQ) were used to assess the sample. Results. The PAI showed strong discriminative ability in detecting PDD, characterized by high scores in cognitive and emotional depression, and low scores in identity alteration, dominance, and grandeur. High scores in cognitive, emotional, and physiological depression, identity alteration, cognitive anxiety, and suicidal ideation, along with low scores in dominance and grandeur, were needed to detect MD with PDD. Discriminant analysis could differentiate 69.6-73.9% of the PDD group and 84.6% of the PDD+MD group. Group comparisons showed that 72.2% of patients with an affective disorder by PAI were correctly classified in the MCMI-III affective disorder group, and 70% without affective disorder were correctly classified. Conclusions. The PAI effectively identifies PDD in FM patients and detects concurrent MD episodes, aiding in better prognostic and therapeutic guidance.

Background: Fibromyalgia (FM) is a complex rheumatic disorder characterized by chronic nociplastic pain and central sensitization. Psychopathological conditions can influence FM symptoms, which worsen their condition. However, not all patients with FM have psychopathological disorders, indicating a heterogeneous population.Objective: To investigate the psychopathological profile and personality disorders in patients with FM and its relationship impact on this disease.Methods: An observational and cross-sectional comparative study was conducted with a sample of 90 women, mean age 48.7 years (SD = 8.12), from Hospital del Mar, Barcelona. The Personality Assessment Inventory (PAI) and the Fibromyalgia Impact Questionnaire (FIQ) were used for assessment.Results: FM patients predominantly exhibited psychopathological profiles resembling affective disorders (37.7%) and Cluster C personality disorders (58.8%). The severity of FM’s impact was related to affective disorder symptoms, hypervigilance, derealization, somatization, and Cluster B personality disorder (emotional instability). Different rheumatic symptoms correlated with specific psychopathological patterns. Increased somatic symptoms on the FIQ were related to an unstable and dependent personality, while heightened emotional symptoms on the FIQ were associated with avoidance, borderline traits, and passive-aggressive reactions.Conclusion: Recognizing psychopathological aspects is crucial for managing FM. The PAI is a valuable tool for establishing its psychopathological multidimensional profile, which predominantly shows an affective spectrum conditions and comorbid Cluster C personality disorder, exacerbating the disease’s impact.

Background: Personality traits are relevant for pain perception in persistent pain disorders, although they have not been studied in depth in sensitized and nonsensitized patients with knee osteoarthritis (OA). Objective: To explain and compare the personality profile of patients with OA, with and without central sensitization (CS), and fibromyalgia (FM). Setting: Participants were selected at the Rheumatology Department in two major hospitals in Spain. Participants: Case-control study where the sample consists of 15 patients with OA and CS (OA-CS), 31 OA without CS (OA-noCS), 47 FM, and 22 controls. We used a rigorous and systematic process that ensured the sample strictly fulfilled all the inclusion/exclusion criteria, so the sample is very well delimited. Primary outcome measures: Personality was assessed by the Temperament and Character Inventory of Cloninger. Results: The percentile in harm-avoidance dimension for the FM group is higher compared to OA groups and controls. The most frequent temperamental profiles in patients are cautious, methodical, and explosive. Patients with FM are more likely to report larger scores in harm-avoidance, with an increase in logistic regression adjusted odds ratio (OR_adj) between 4.2% and 70.2%. Conclusions: Harm-avoidance seems to be the most important dimension in personality patients with chronic pain, as previously found. We found no differences between OA groups and between sensitized groups, but there are differences between FM and OA-noCS, so harm-avoidance might be the key to describe personality in patients with CS rather than the presence of prolonged pain, as found in the literature before.