Abstract

Aim: This single-center cross-sectional study aimed to investigate the clinical, demographic, and psychological characteristics of patients with fibromyalgia (FM) and assess the impact of these parameters on quality of life, daily functioning, and psychological well-being.

Materials and Methods: Eighty-six women diagnosed with FM according to the 1990 ACR criteria were included. Socio-demographic, clinical, and psychometric characteristics were recorded. The severity of pain was assessed with the Visual Analog Scale (VAS), while the Fibromyalgia Impact Questionnaire (FIQ), Nottingham Health Profile (NHP), Hamilton Anxiety (HAM-A), and Depression (HAM-D) scales, Symptom Checklist-90-R (SCL90-R), and Modified Fatigue Impact Scale were used to evaluate disease severity, quality of life, and psychological symptoms, respectively. Physical activity level, hand grip strength, 100-meter walking time, and tender point counts were also recorded.

Results: Major anxiety was detected in 61.6% and moderate-to-severe depression in 38.4% of participants. Pain levels (VAS) showed a significant positive correlation with both functional disability (FIQ) and depression (HAM-D). Physical activity was inversely associated with fatigue scores (p=0.039). No significant associations were found between BMI and most clinical parameters, except for walking time. SCL90-R scores indicated elevated somatization and psychological distress in a substantial subgroup.

Conclusion: FM adversely affects quality of life and is commonly accompanied by psychological symptoms. Comprehensive assessment strategies addressing both physical and psychological aspects are essential for effective management. 

Keywords: Fibromyalgia, depression, anxiety, quality of life

Copyright and license

How to cite

1.
Baykal Şahin H, Karkucak M, Çapkın E. Quality of life, psychological status, and functionality in patients with fibromyalgia. Northwestern Med J. 2026;Early View:95-102. https://doi.org/10.54307/2026.NWMJ.198

References

  1. Bellato E, Marini E, Castoldi F, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012; 2012: 426130. https://doi.org/10.1155/2012/426130
  2. Siracusa R, Paola RD, Cuzzocrea S, Impellizzeri D. Fibromyalgia: pathogenesis, mechanisms, diagnosis and treatment options update. Int J Mol Sci. 2021; 22(8): 3891. https://doi.org/10.3390/ijms22083891
  3. Wolfe F, Brähler E, Hinz A, Häuser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthritis Care Res (Hoboken). 2013; 65(5): 777-85. https://doi.org/10.1002/acr.21931
  4. Topbas M, Cakirbay H, Gulec H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol. 2005; 34(2): 140-4.
  5. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010; 62(5): 600-10. https://doi.org/10.1002/acr.20140
  6. Güven AZ, Kul Panza E, Gündüz OH. Depression and psychosocial factors in Turkish women with fibromyalgia syndrome. Eura Medicophys. 2005; 41(4): 309-13.
  7. Kurland JE, Coyle WJ, Winkler A, Zable E. Prevalence of irritable bowel syndrome and depression in fibromyalgia. Dig Dis Sci. 2006; 51(3): 454-60. https://doi.org/10.1007/s10620-006-3154-7
  8. Thieme K, Turk DC, Flor H. Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables. Psychosom Med. 2004; 66(6): 837-44. https://doi.org/10.1097/01.psy.0000146329.63158.40
  9. Okifuji A, Turk DC, Sherman JJ. Evaluation of the relationship between depression and fibromyalgia syndrome: why aren’t all patients depressed? J Rheumatol. 2000; 27(1): 212-9.
  10. Arnold LM, Hudson JI, Keck PE, Auchenbach MB, Javaras KN, Hess EV. Comorbidity of fibromyalgia and psychiatric disorders. J Clin Psychiatry. 2006; 67(8): 1219-25. https://doi.org/10.4088/jcp.v67n0807
  11. Verbunt JA, Pernot DH, Smeets RJ. Disability and quality of life in patients with fibromyalgia. Health Qual Life Outcomes. 2008; 6: 8. https://doi.org/10.1186/1477-7525-6-8
  12. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000; 20(1): 9-12. https://doi.org/10.1007/s002960000077
  13. Yazıcı MK, Demir B, Tanrıverdi N, Karaağaoğlu E, Yolaç P. Hamilton Anxiety Rating Scale: interrater reliability and validity study. Turk Psikiyatri Derg. 1998; 9(2): 114-7.
  14. Akdemir A, Örsel S, Dağ D, Turkcapar H, İşcan N, Özbay H. Hamilton Depresyon Derecelendirme Ölçeğinin geçerliliği, güvenilirliği ve klinikte kullanımı. Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 1996; 4(4): 251-9.
  15. Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000; 23(1): 31-8. https://doi.org/10.1097/00004356-200023010-00004
  16. Dağ İ. Reliability and validity of the Symptom Check List (SCL-90-R) for university students. Turk Psikiyatri Derg. 1991; 2(1): 5-12.
  17. Turkyilmaz AK, Kurt EE, Karkucak M, Capkin E. Sociodemographic characteristics, clinical signs and quality of life in patients with fibromyalgia. Eurasian J Med. 2012; 44(2): 88-93. https://doi.org/10.5152/eajm.2012.21
  18. Sezgin Özcan D, Aras M, Köseoğlu BF, Şentürk Güven Ş. Quality of life and associated conditions in women with fibromyalgia syndrome. Turk J Osteoporos. 2013; 19(2): 42-7. https://doi.org/10.4274/tod.38258
  19. Pagano T, Matsutani LA, Ferreira EA, Marques AP, Pereira CA. Assessment of anxiety and quality of life in fibromyalgia patients. Sao Paulo Med J. 2004; 122(6): 252-8. https://doi.org/10.1590/s1516-31802004000600005
  20. Jones KD, Mist SD, Casselberry MA, Ali A, Christopher MS. Fibromyalgia impact and mindfulness characteristics in 4986 people with fibromyalgia. Explore (NY). 2015; 11(4): 304-9. https://doi.org/10.1016/j.explore.2015.04.006
  21. Segura-Jiménez V, Álvarez-Gallardo IC, Carbonell-Baeza A, et al. Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: the al-Ándalus project. Semin Arthritis Rheum. 2015; 44(5): 563-70. https://doi.org/10.1016/j.semarthrit.2014.09.010
  22. dos Santos EB, Quintans Junior LJ, Fraga BP, Macieira JC, Bonjardim LR. An evaluation of anxiety and depression symptoms in fibromyalgia. Rev Esc Enferm USP. 2012; 46(3): 590-6. https://doi.org/10.1590/s0080-62342012000300009
  23. Altunören Ö, Orhan FÖ, Nacitarhan V, Özer A, Karaaslan MF, Altunören O. Evaluation of depression, temperament and character profiles in female patients with fibromyalgia syndrome. Archives of Neuropsychiatry. 2011; 48: 31-8. https://doi.org/10.4274/npa.y5667
  24. Balasubramaniam R, de Leeuw R, Zhu H, Nickerson RB, Okeson JP, Carlson CR. Prevalence of temporomandibular disorders in fibromyalgia and failed back syndrome patients: a blinded prospective comparison study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104(2): 204-16. https://doi.org/10.1016/j.tripleo.2007.01.012
  25. Kirmayer LJ, Robbins JM, Kapusta MA. Somatization and depression in fibromyalgia syndrome. Am J Psychiatry. 1988; 145(8): 950-4. https://doi.org/10.1176/ajp.145.8.950
  26. Acar Sivas F, Mermerci Başkan B, Akbulut Aktekin L, Kılıç Çınar N, Gül Yurdakul F, Özoran K. Assessment of depression, sleep disorders and quality of life in patients with fibromyalgia. Turk J Phys Med Rehab. 2009; 55: 8-12.
  27. Wigers SH. Fibromyalgia outcome: the predictive values of symptom duration, physical activity, disability pension, and critical life events-a 4.5 year prospective study. J Psychosom Res. 1996; 41(3): 235-43. https://doi.org/10.1016/0022-3999(96)00070-0
  28. Kaleth AS, Saha CK, Jensen MP, Slaven JE, Ang DC. Effect of moderate to vigorous physical activity on long-term clinical outcomes and pain severity in fibromyalgia. Arthritis Care Res (Hoboken). 2013; 65(8): 1211-8. https://doi.org/10.1002/acr.21980
  29. Häuser W, Bernardy K, Arnold B, Offenbächer M, Schiltenwolf M. Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials. Arthritis Rheum. 2009; 61(2): 216-24. https://doi.org/10.1002/art.24276
  30. Granges G, Zilko P, Littlejohn GO. Fibromyalgia syndrome: assessment of the severity of the condition 2 years after diagnosis. J Rheumatol. 1994; 21(3): 523-9.
  31. Arranz LI, Rafecas M, Alegre C. Effects of obesity on function and quality of life in chronic pain conditions. Curr Rheumatol Rep. 2014; 16(1): 390. https://doi.org/10.1007/s11926-013-0390-7
  32. Yılmaz H, Erkin G, Küçükşen S, Akkurt E. Correlation between body mass index and clinical parameters in fibromyalgia syndrome. Selcuk Med J. 2013; 29(1): 12-5.
  33. Kim CH, Luedtke CA, Vincent A, Thompson JM, Oh TH. Association of body mass index with symptom severity and quality of life in patients with fibromyalgia. Arthritis Care Res (Hoboken). 2012; 64(2): 222-8. https://doi.org/10.1002/acr.20653
  34. Aparicio VA, Ortega FB, Carbonell-Baeza A, Camiletti D, Ruiz JR, Delgado-Fernández M. Relationship of weight status with mental and physical health in female fibromyalgia patients. Obes Facts. 2011; 4(6): 443-8. https://doi.org/10.1159/000335293
  35. Gota CE, Kaouk S, Wilke WS. Fibromyalgia and obesity: the association between body mass index and disability, depression, history of abuse, medications, and comorbidities. J Clin Rheumatol. 2015; 21(6): 289-95. https://doi.org/10.1097/RHU.0000000000000278
  36. Shapiro JR, Anderson DA, Danoff-Burg S. A pilot study of the effects of behavioral weight loss treatment on fibromyalgia symptoms. J Psychosom Res. 2005; 59(5): 275-82. https://doi.org/10.1016/j.jpsychores.2005.06.081
  37. Senna MK, Sallam RA, Ashour HS, Elarman M. Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial. Clin Rheumatol. 2012; 31(11): 1591-7. https://doi.org/10.1007/s10067-012-2053-x