Singh Ruchi, Rai Nirendra Kumar, Pathak Akash, Rai Jyotsana, Pakhare Abhijit, Kashyap Priyanka Vikas, Rozatkar Abhijit R, Mishra Shweta, Mudda Sofia
Department of Physiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Department of Neurology, Visiting Faculty, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
J Neurosci Rural Pract. 2024 Apr-Jun;15(2):320-326. doi: 10.25259/JNRP_14_2024. Epub 2024 Apr 18.
Fibromyalgia syndrome (FMS) is characterized by persistent widespread pain which greatly impacts the quality of life (QOL). Pain not only limits patients' daily activities but also restricts their social activities further leading to depression, anxiety, and stress. The present cross-sectional study elucidated the association of sleep quality and mood with increasing symptom severity of fibromyalgia and its impact on the QOL of fibromyalgia patients.
Hundred adult fibromyalgia patients diagnosed by the American College of Rheumatology 2010 criteria were evaluated for: sleep - using the Pittsburgh sleep quality index, QOL by SF-36, pain-visual analog scales (VASs) and global pain scale (GPS), mood-depression, anxiety, stress scale-21, somatic symptoms, anxiety and depression - by patients health questionnaire somatic, anxiety, and depressive symptom scales (PHQ-SADS), and FMS severity was evaluated using fibromyalgia impact questionnaire (FIQR).
The mean pain score was 6.80 ± 1.58 on VAS and 54.10 ± 14.33 on GPS. FIQR score was 50.62 ± 13.68, mean sleep quality was poor (9.30 ± 3.88), and depression, anxiety, and stress scores were increased (10.04 ± 4.59, 8.33 ± 4.48, and 10.75 ± 4.66). An increasing trend of depression, anxiety, stress, and somatoform symptoms was observed with an increase in the severity of FMS when patients were compared according to FMS severity scores. Sleep also deteriorated with increasing severity of FMS from 5.66 ± 1.92 in mild FMS to 12.0 ± 3.41 in highly severe FMS patients. The QOL too deteriorated in all the domains with increasing severity.
With the increasing severity of fibromyalgia, not only does the pain increase but mood and sleep quality also deteriorate, which further impacts the QOL of FMS patients. Thus, comorbid mood derangements must also be screened and addressed for maximum benefit of the patients.
纤维肌痛综合征(FMS)的特征是持续性全身疼痛,这对生活质量(QOL)有极大影响。疼痛不仅限制患者的日常活动,还会进一步限制其社交活动,进而导致抑郁、焦虑和压力。本横断面研究阐明了睡眠质量和情绪与纤维肌痛症状严重程度增加之间的关联及其对纤维肌痛患者生活质量的影响。
对100名根据美国风湿病学会2010年标准诊断的成年纤维肌痛患者进行评估:睡眠——使用匹兹堡睡眠质量指数;生活质量——采用SF - 36量表;疼痛——视觉模拟量表(VAS)和整体疼痛量表(GPS);情绪——抑郁、焦虑、压力量表 - 21;躯体症状、焦虑和抑郁——采用患者健康问卷躯体、焦虑和抑郁症状量表(PHQ - SADS),并使用纤维肌痛影响问卷(FIQR)评估FMS严重程度。
VAS平均疼痛评分为6.80±1.58,GPS评分为54.10±14.33。FIQR评分为50.62±13.68,平均睡眠质量较差(9.30±3.88),抑郁、焦虑和压力评分升高(分别为10.04±4.59、8.33±4.48和10.75±4.66)。根据FMS严重程度评分对患者进行比较时,随着FMS严重程度增加,观察到抑郁、焦虑、压力和躯体形式症状呈上升趋势。随着FMS严重程度增加,睡眠也恶化,从轻度FMS患者的5.66±1.92降至高度严重FMS患者的12.0±3.41。随着严重程度增加,所有领域的生活质量也均恶化。
随着纤维肌痛严重程度增加,不仅疼痛加剧,情绪和睡眠质量也会恶化,这进一步影响FMS患者的生活质量。因此,为使患者获得最大益处,还必须筛查并处理合并的情绪紊乱问题。