Quality of life and psychological assessment in patients with Fibromyalgia Syndrome during COVID-19 pandemic in Italy: prospective observational study
1Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37134 Verona, Italy
2Department of Medicine and Public Health, University of Verona, 37134 Verona, Italy
3Fondazione Paolo Procacci and European League against Pain, 00185 Rome, Italy
Submitted: 22 April 2021 Accepted: 30 June 2021
Online publish date: 14 July 2021
Introduction: Chronic pain patients who undergo to stressful events may experience worsening in pain, sleep, and quality of life (QoL). The primary objective of this observational study was to compare QoL and sleep parameters before and after the COVID-19 lockdown in patients with Fibromyalgia Syndrome (FMS). The psychological impact of lockdown was also assessed, as well as the emotional impact of the pandemic and its correlations with patient socio-demographics.
Methods: Patients aged ≥18 years with FMS diagnosed according to ACR (American College of Rheumatology) 2016 Criteria with at least one pre-pandemic QoL and sleep evaluation were included. QoL and sleep disturbances were analyzed by comparing scores on the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), the 12-item Short Form Survey (SF-12), and the Pittsburgh Sleep Quality Index (PSQI) before and after the first lockdown in Italy (March to May 2020). Psychological impact was investigated via a 52-item survey of daily life changes in FMS management during the lockdown and emotional impact with the Impact Event Scale-Revised (IES-R) tool during the onset period after the lockdown. Questionnaire responses were correlated with patients’ socio-demographics.
Results: Questionnaires were submitted via email to 54 patients; 37/54 patients (63.7%) returned them. QoL and sleep disturbances showed no statistically significant worsening. However, the psychological impact survey revealed that 3 out of 5 patients feared very much for their family members’ lives during lockdown. The emotional impact survey disclosed 72.7% of patients with psychological distress.
Conclusions: While questionnaire responses showed no significant changes in QoL and sleep after the COVID-19 lockdown in this sample of FMS patients, the emotional investigation revealed moderate/severe psychological distress not detected by commonly used QoL tests in FMS.
Fibromyalgia; Quality of life; Depression; Sleep; COVID-19 pandemic
Vittorio Schweiger,Erica Secchettin,Giovanni Perini,Alvise Martini,Katia Donadello,Leonardo Gottin,Giovanna Del Balzo,Giustino Varrassi,Enrico Polati. Quality of life and psychological assessment in patients with Fibromyalgia Syndrome during COVID-19 pandemic in Italy: prospective observational study. Signa Vitae. 2021.doi:10.22514/sv.2021.127.
 Clauw DJ, Arnold LM, McCarberg BH. The Science of Fibromyalgia. Mayo Clinic Proceedings. 2011; 86: 907–911.
 Schweiger V, Del Balzo G, Raniero D, De Leo D, Martini A, Sarzi-Puttini P, et al. Current trends in disability claims due to fibromyalgia syndrome. Clinical and Experimental Rheumatology. 2017; 35: 119–126.
 Coaccioli S, Varrassi G, Sabatini C, Marinangeli F, Giuliani M, Puxeddu A. Fibromyalgia: nosography and therapeutic perspectives. Pain Practice. 2008; 8: 190–201.
 Rahman A, Underwood M, Carnes D. Fibromyalgia. British Medical Journal. 2014; 348: g1224.
 Yasui M, Yoshimura T, Takeuchi S, Tokizane K, Tsuda M, Inoue K, et al. A chronic fatigue syndrome model demonstrates mechanical allodynia and muscular hyperalgesia via spinal microglial activation. Glia. 2015; 62: 1407–1417.
 Salaffi F, Atzeni F, Talotta R, Di Carlo M, Sarzi-Puttini P. Earthquake vulnerability of fibromyalgia patients: six-month follow-up after the catastrophic disasters in central Italy. Clinical and Experimental Rheumatology. 2017; 35: 93–99.
 Usui C, Hatta K, Aratani S, Yagishita N, Nishioka K, Okamura S, et al. Vulnerability to traumatic stress in fibromyalgia patients: 19 month follow-up after the great East Japan disaster. Arthritis Research & Therapy. 2013; 15: R130.
 Allen SF, Stevenson J, Lazuras L, Akram U. The role of the COVID-19 pandemic in altered psychological well-being, mental health and sleep: an online cross-sectional study. Psychology, Health & Medicine. 2021; 1–9.
 Souza LFF, Paineiras-Domingos LL, Melo-Oliveira MES, Pessanha-Freitas J, Moreira-Marconi E, Lacerda ACR, Mendonça VA, Sá-Caputo DDC, Bernardo-Filho M. The impact of COVID-19 pandemic in the quality of sleep by Pittsburgh Sleep Quality Index: a systematic review. Ciência & Saúde Coletiva. 2021; 26: 1457–1466.
 Soares LL, Leite LB, Guilherme LQ, Rezende LM, Noce F, Pussieldi G. Anxiety, sleep quality and mood in elite athletes during the COVID-19 pandemic: a preliminary study. The Journal of Sports Medicine and Physical Fitness. 2021. (in press)
 Sonza A, Da Cunha de Sá-Caputo D, Bachur JA, Rodrigues de Araújo MDG, Valadares Trippo KVT, Ribeiro Nogueira da Gama DRNDG, et al. Brazil before and during COVID-19 pandemic: impact on the practice and habits of physical exercise. Acta BioMedica. 2020; 92: e2021027.
 Melo-Oliveira ME, Sá-Caputo D, Bachur JA, Paineiras-Domingos LL, Sonza A, Lacerda AC, et al. Reported quality of life in countries with cases of COVID19: a systematic review. Expert Review of Respiratory Medicine. 2021; 15: 213–220.
 Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Research & Therapy. 2009; 11: R120.
 Hoffman DL, Dukes EM. The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12. International Journal of Clinical Practice. 2008; 62: 115–126.
 Osorio CD, Gallinaro AL, Lorenzi-Filho G, Lage LV. Sleep quality in patients with fibromyalgia using the Pittsburgh Sleep Quality Index. Journal of Rheumatology. 2006; 33: 1863–1865.
 Craparo G, Faraci P, Rotondo G, Gori A. The Impact of Event Scale -Revised: psychometric properties of the Italian version in a sample of flood victims. Neuropsychiatric Disease and Treatment. 2013; 9: 1427–1432.
 Martini A, Schweiger V, Del Balzo G, Sartori G, Parolini M, Chinellato E, et al. Epidemiological, pharmacological and sociodemographic characterization of a population of 386 fibromyalgic patients referred to a tertiary pain centre in Italy. Clinical and Experimental Rheumatology. 2019; 37: 27–38.
 Osimo SA, Aiello M, Gentili C, Ionta S, Cecchetto C. The influence of personality, resilience, and alexithymia on mental health during COVID-19 Pandemic. Frontiers in Psychology. 2021; 4: 630751.
 Cecchetto C, Aiello M, Gentili C, Ionta S, Osimo SA. Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress. Appetite. 2021; 160: 105122.
 Conversano C, Marchi L, Rebecca C, Carmassi C, Contena B, Bazzichi LM, et al. Personality Traits in Fibromyalgia (FM): does FM personality exists? a Systematic Review. Clinical Practice and Epidemiology in Mental Health. 2018; 14: 223–232.
 Cavalli G, Cariddi A, Ferrari J, Suzzi B, Tomelleri A, Campochiaro C, et al. Living with fibromyalgia during the COVID-19 pandemic: mixed effects of prolonged lockdown on the well-being of patients. Rheumatology. 2021; 60: 465–467.
 Jeppesen SS, Bentsen KK, Jørgensen TL, Holm HS, Holst-Christensen L, Tarpgaard LS, et al. Quality of life in patients with cancer during the COVID-19 pandemic – a Danish cross-sectional study (COPICADS). Acta Oncologica. 2021; 60: 4–12.
 Ciążynska M, Pabianek M, Szczepaniak K, Ułanska M, Skibinska M, Owczarek W, et al. Quality of life of cancer patients during coronavirus disease (COVID-19) pandemic. Psycho-Oncology. 2020; 1–3.
 Deledda G, Riccardi N, Gori S, Poli S, Giansante M, Geccherle E, et al. The impact of the SARS-CoV-2 outbreak on the psychological flexibility and behavior of cancelling medical appointments of italian patients with pre-existing medical condition: The “ImpACT-COVID-19 for patients” multi-centre observational study. International Journal of Environmental Research and Public Health. 2021; 18: 340.
 Passavanti M, Argentieri A, Barbieri DM, Lou B, Wijayaratna K, Foroutan Mirhosseini AS, et al. The psychological impact of COVID-19 and restrictive measures in the world. Journal of Affective Disorders. 2021; 283: 36–51.
 Regier DA, Kuhl EA, Kupfer DJ. The DSM-5: Classification and criteria changes. World Psychiatry. 2013; 12: 92–98.
 O’Donnell ML, Agathos JA, Metcalf O, Gibson K, Lau W. Adjustment Disorder: Current Developments and Future Directions. International Journal of Environmental Research and Public Health. 2019; 16: 2537.
 Arnold LM, Crofford LJ, Mease PJ, Burgess SM, Palmer SC, Abetz L, et al. Patient perspectives on the impact of fibromyalgia. Patient Education and Counseling. 2008; 73: 114–120.
 Jenkinson C, Peto V, Fitzpatrick R, Greenhall R, Hyman N. Self-reported functioning and well-being in patients with Parkinson’s disease: comparison of the short-form health survey (SF-36) and the Parkinson’s Disease Questionnaire (PDQ-39) Age and Ageing. 1995; 24: 505–509.
 Spaeth M, Rizzi M, Sarzi-Puttini P. Fibromyalgia and sleep. Best Practice & Research. Clinical Rheumatology. 2011; 25: 227–239.
 Hruschak V, Flowers KM, Azizoddin DR, Jamison RN, Edwards RR, Schreiber KL. Cross-sectional study of psychosocial and pain-related variables among patients with chronic pain during a time of social distancing imposed by the coronavirus disease 2019 pandemic. Pain. 2021; 162: 619–629.
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