Poor Illness Perceptions Are a Risk Factor for Depressive and Anxious Symptomatology in Fibromyalgia Syndrome: A Longitudinal Cohort Study study published online November 1st, 2017 in Frontiers in Psychiatry

Depression and anxiety are highly comorbid with fibromyalgia and the objective of the study was to determine whether severe pain, maladaptive coping, and poor illness perception are associated with anxiety and depression in FM subjects. 280 patients did a baseline questionnaire. Depressive and anxious symptomatology was measured. Fibromyalgia Impact Questionnaire was used to measure coping, illness perception, and pain severity. As were the Pain Coping Inventory and Perception Questionnaire.

Mean age was 42.6 and 95.4% were female.

At 18 month follow-up 58( out of 195) were depressed. And 80 (of 197) were anxious.

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Conclusion: “Our data suggest that not pain severity or maladaptive coping, but poor illness perceptionsare important in elevated depressive and anxious symptomatology. Patients with fibromyalgia who think their illness negatively affects their mental well-being are at increased risk for more depressive symptoms, and those who think treatment of their illness will not be effective are at increased risk for more anxiety symptoms. Strengthening illness beliefs and reducing catastrophic thinking, therefore, seem crucial factors in the treatment of patients with FMS.”

To the authors’ knowledge, this is the first study to document on pain, illness perception, and coping style as risk factors for depressive and anxious symptomatology in patients with FMS. The results here indicate that patients with FMS who believe their illness will have a negative effect on their mental well-being, who also have elevated levels of depressive symptoms, are more likely to be depressed on subsequent occasions. Furthermore, patients with FMS who think that treatment of their illness will not be effective and who also have elevated levels of anxiety symptoms are more likely to be anxious on subsequent occasions. Our hypothesis that poor illness perceptions are a risk factor for depressive and anxious symptomatology is therefore confirmed.

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Typically one might think pain itself to be a primary influencer for depression and anxiety. In my experience it seems to be. However this particular study suggests otherwise.

What we can take away from studies like these is that by ‘strengthening illness beliefs’ and reducing catastrophic thinking we can help those of us with fibromyalgia adapt and improve our wellbeing. Quite frankly pain beliefs and perceptions always do play a big role in coping and management of chronic pain, so it is something we do have to pay attention to. More so if it is a risk factor for depression and anxiety.

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