Beyond pain: the influence of psychological factors on functional status in fibromyalgia

Fibromyalgia (FM) is characterised by chronic widespread pain, often associated with fatigue, sleep disturbance, cognitive and mood impairment. Pain is a complex and multidimensional experience that significantly impacts personal, social, and professional functioning. Psychological factors related to chronic pain include catastrophising and self-efficacy in managing the painful condition. Therefore, this study explores the influence of chronic pain and related psychological factors on functional outcomes in FM patients.

In this study, 91 Italian patients with FM were assessed using an online questionnaire. The questionnaire included instruments to assess pain, such as the Numerical Rating Scale (NRS) and the Brief Pain Inventory (BPI), psychological characteristics, such as the Pain Self-Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS), and health-related quality of life with the 12-item Short Form Survey (SF-12). Multiple regression models were run, using the Interference subscale of the BPI and the physical and mental components of the SF-12 as outcomes, and the NRS, PCS and PSEQ scales as predictors.

Our analysis revealed that in our model, both PCS and PSEQ were significant predictors of BPI-Interference (PCS: β=0.29; p=0.001; PSEQ: β=-0.36; p<0.001); NRS and PSEQ significantly predicted SF-12-Physical score (NRS: β=-0.32; p=<0.001; PSEQ: β=.50; p<0.001); PCS was found to be the only significant predictor of SF-12-Mental scores (β=-0.53; p<0.001).

Our results suggested that psychological variables such as catastrophic thinking and self-efficacy play a significant role in determining daily functioning and physical and mental health status in FM patients, showing greater influence than pain intensity.