Background & Aims

Fibromyalgia (FM) is a chronic pain disease affecting between 2-4% of the general population, predominantly women (Häuser & Fitzcharles, 2018). It is often accompanied by other symptoms, including mood symptoms. Major depressive disorder (MDD) is characterized by low mood and negative views about the self, the world and the future (Hard et al., 2020). Fibromyalgia and depression are bidirectionally related, sharing clinical symptoms (i.e., fatigue, sleep disturbances, cognitive dysfunction), pathophysiological processes and precipitating/perpetuating factors (Yepez et al., 2022).
To our knowledge, no study has compared self-identity and measures of self-esteem between adult patients with FM versus MDD (compared to controls), which would be relevant to better characterize the overlapping and differential symptoms observed in these conditions.

Methods

38 adult patients with FM (mean age=48.18±11.2), 16 MDD patients (mean age=48.37±11.29) and 37 controls (mean age=46.08±16.23) (p=0.755) were included. Groups did not differ in years of education (p=0.33) or income (p=0.105). Participants completed the Twenty Statements Test (TST), a measure of self-concept in which they freely wrote 20 statements about their current self. The statements were rated based on their valence by four independent researchers. The statements were then classified into categories according to their content.
Participants also underwent a task, where personality trait words were shown either in red (self-judgement condition) or green (vowel-counting condition). During “red” blocks, participants responded with dichotomous yes/no answers whether each trait word described them currently. Blocks were also divided in general-traits (disrespectful, loyal) and disease-related (worried, energized). One-way ANOVA and two-sample t-tests were performed.

Results

Regarding the TST, the MDD group had the lowest mean valence of the reported statements, followed by FM, and controls. Significant differences were found when comparing controls with FM patients (T=6.84); controls with MDD patients (T=12.18); and FM with MDD (T=7.46) (all p’s<0.001). Both disease groups scored lower than controls in “physical aspect”, “personality traits”, “skills” and “disease related” categories of the TST (all p’s<0.05); MDD patients always showed the lowest (most negatively valenced) scores, followed by FM. In the self-judgement task, FM and MDD felt that general positive traits described them significantly less than controls (T>=2.8, p’s<0.01). Differences were much higher for disease-related words: FM and MDD patients felt more identified than controls to negative traits (T>=5.83, p’s<0.001) and less to positive ones (T=8.04, T=6.15, p’s<0.001). After self-judging, MDD felt worse than FM, and FM worse than controls (F=209.5, p<0.001).

Conclusions

MDD patients’ global self-identity is strongly impaired, followed by FM patients, and such poor self-concept spans across many aspects of the self (personality, abilities, physical aspect…) following the same pattern (MDD>FM>controls). Regarding the self-vowel task, despite no significant differences being found on the identification with traits between FM and MDD, depression is accompanied with more negative feelings after self-judgement processes. Self-identity in FM is affected similarly to major depression, especially when confronting salient aspects (disease-related ones).

References

Hards, E., Ellis, J., Fisk, J., & Reynolds, S. (2020). Negative view of the self and symptoms of depression in adolescents. Journal of Affective Disorders, 262, 143–148. https://doi.org/10.1016/j.jad.2019.11.012

Häuser, W., & Fitzcharles, M. A. (2018). Facts and myths pertaining to fibromyalgia. Dialogues in Clinical Neuroscience, 20(1), 53–62. https://doi.org/10.31887/DCNS.2018.20.1/whauser

Yepez, D., Grandes, X. A., Talanki Manjunatha, R., Habib, S., & Sangaraju, S. L. (2022). Fibromyalgia and Depression: A Literature Review of Their Shared Aspects. Cureus, 14(5), e24909. https://doi.org/10.7759/cureus.24909

Presenting Author

Miguel Montero

Poster Authors

Miguel Montero

MSc

University of Barcelona

Lead Author

E-mail

Maria Suñol

PhD

University of Barcelona

Lead Author

E-mail

Laura Martín Herrero

University of Barcelona

Lead Author

E-mail

Lucia Blanc

BSc

University of Barcelona

Lead Author

E-mail

Ana Arias

BSc

Hospital Clinic de Barcelona

Lead Author

E-mail

Tamara Rodríguez

MD

Hospital Clinic de Barcelona

Lead Author

E-mail

Xavier Torres

PhD

Hospital Clinic de Barcelona

Lead Author

E-mail

Myriam Cavero

MD

Hospital Clinic de Barcelona

Lead Author

E-mail

Marc Valentí

MD

Hospital Clinic de Barcelona

Lead Author

E-mail

Luciano Polino

MD

Hospital Clinic de Barcelona

Lead Author

E-mail

Marina López-Sola

Phd

University of Barcelona

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Fibromyalgia