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Psychological Resilience in Fibromyalgia: The Impact of Mental Health on Clinical Progression

Published online by Cambridge University Press:  26 August 2025

T. Mutlu Topal*
Affiliation:
Psychiatry
H. Ertekin
Affiliation:
Psychiatry
H. Reşorlu
Affiliation:
Physical Therapy and Rehabilitation, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
*
*Corresponding author.

Abstract

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Introduction

Fibromyalgia (FM) is a chronic condition characterized by widespread muscle pain,with an unclear etiology. Pain-related behaviors are often closely tied to the individual’s mental state. This has made FM a significant area of psychiatric research, highlighting the need to understand the psychological factors that influence disease progression.

Objectives

We aim to explore differences in psychological resilience between FM patients and healthy controls and its relationship with depression,anxiety,and fibromyalgia symptoms. Specifically,we seek to understand how resilience may influence disease development and progression. By examining these factors, the study aims to clarify the underlying causes of fibromyalgia,is closely linked to psychiatric factors and remains poorly understood in terms of etiology.

Methods

The study included FM patients treated at the Department of Physical Medicine and Rehabilitation at Çanakkale 18 Mart University and a control group of healthy volunteers matched for demographic factors. Pain intensity was measured using the Visual Analog Scale(VAS) and functional disability was assessed with the Fibromyalgia Impact Questionnaire(FIQ). Participants completed sociodemographic forms, the Beck Anxiety Inventory(BAI), the Beck Depression Inventory(BDI), and the Psychological Resilience Scale(PRS).

Results

The study involved 40 female patients with FM and 35 healthy controls. No significant differences were found between the two groups in terms of demographic factors. The FM group showed significantly higher scores for BDI,BAI and PRS compared to controls (p<0.001 for BDI and BAI; p =0.04 for PRS). Correlation analysis revealed significant negative correlations between pain intensity and both PRS total and PRS dedication scores (r=-0.34, p=0.02; r =-0.35, p =0.02). Additionally,FIQ scores were negatively correlated with PRS dedication scores(r=-0.37, p=0.01). (Table 1).

Table 1: Psychological Status and Performance Scales (BDI, BAI, PRS, etc.)

VariableFM (n, %) & mean ± SDControl (n, %) & mean ± SDStatisticsp
BDI20.20 ± 11.547.77 ± 6.795.58<0.001
BAI24.90 ± 13.149.0 ± 6.976.40<0.001
PRS Total54.92 ± 10.6759.08 ± 10.27-1.710.09
Challenge21.22 ± 5.8221.11 ± 5.500.080.93
Dedication17.75 ± 5.1419.54 ± 4.24-1.630.10
Control16.25 ± 5.0118.38 ± 3.70-2.050.04

BMI: Body Mass Index, BDI: Beck Depression Inventory, BAI: Beck Anxiety Inventory, PRS: Psychological Resilience Scale

Conclusions

This study highlights the complex interplay between psychological resilience,depression,anxiety and pain in FM patients. Psychological resilience was not significantly lower in FM patients compared to healthy individuals,but higher levels of depression and anxiety were inversely related to resilience.These findings underscore the need for treatment approaches that not only address physical symptoms but also aim to enhance psychological resilience in order to improve the overall quality of life in FM patients.

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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