Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: the al-Ándalus project

Semin Arthritis Rheum. 2015 Apr;44(5):563-570. doi: 10.1016/j.semarthrit.2014.09.010. Epub 2014 Sep 28.


Objectives: To characterize a representative sample of fibromyalgia women based on a set of relevant factors known to be related to this disease. To distinguish specific factors of the disease from other symptoms that might also exist in non-fibromyalgia women. To test whether fibromyalgia affects more severely physical or psychological outcomes.

Methods: A total of 459 fibromyalgia women vs. 214 non-fibromyalgia (control) women from Southern Spain (Andalusia) took part in this cross-sectional study. Several instruments were used to assess tenderness, impact of fibromyalgia, fatigue, health-related quality of life, mental health, and cognitive performance.

Results: Overall, fibromyalgia women showed a worse status in pain, fatigue, health-related quality of life, depression, and anxiety than controls (P < 0.01). In general, the observed associations presented very large effect sizes (Cohen׳s d from ~1 to ~5.5). No differences between fibromyalgia and controls were observed in cognitive and memory performance, except for delayed recall, but the observed effect size was low (~0.25). The effect size observed for the global physical component (~3.3) was larger than that for the global psychological component (~1.3), all P < 0.001.

Conclusions: Our results reinforce the understanding of fibromyalgia as a polysymptomatic distress condition with pain as its main symptom. Our findings support that fibromyalgia seems to have a greater impact on physical than on psychological outcomes, though both are largely affected.

Keywords: Cognitive performance; Health-related quality of life; Impact of fibromyalgia; Mental health; Tenderness; Women.

MeSH terms

  • Adult
  • Cognition / physiology
  • Cross-Sectional Studies
  • Depression / complications*
  • Depression / physiopathology
  • Depression / psychology
  • Fatigue / complications*
  • Fatigue / physiopathology
  • Fatigue / psychology
  • Female
  • Fibromyalgia / complications*
  • Fibromyalgia / physiopathology
  • Fibromyalgia / psychology
  • Health Status
  • Humans
  • Mental Health*
  • Middle Aged
  • Neuropsychological Tests
  • Pain / complications*
  • Pain / physiopathology
  • Pain / psychology
  • Quality of Life / psychology*