[Characterization of the pain, sleep and alexithymia patterns of patients with fibromyalgia treated in a Brazilian tertiary center]

Rev Bras Reumatol. Sep-Oct 2014;54(5):409-13. doi: 10.1016/j.rbr.2014.03.017. Epub 2014 Jul 6.
[Article in Portuguese]


Objectives: Fibromyalgia (FM) is a complex syndrome that is characterized by lasting and diffuse chronic musculoskeletal pain, derived from non-inflammatory causes and classically associated with the presence of specific tender points. However, studies have highlighted other important symptoms associated with a lower quality of life (QOL) in FM, such as sleep disturbances and alexithymia. This study aimed to investigate the pain, sleep and alexithymia patterns of FM patients treated in a Brazilian tertiary center.

Methods: 20 patients with FM who were followed-up in the Rheumatology outpatient clinic of a Brazilian tertiary center (Faculdade de Medicina de São José do Rio Preto - FAMERP, São Paulo, Brazil) and 20 patients without FM from other outpatient services of the FAMERP completed a clinical and socio-demographic questionnaire, the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI), the Toronto Alexithymia Scale (TAS-20) and the SF-36 (WHOQOL).

Results: The patients with FM presented worse performances in all QOL dimensions of the SF-36 and higher scores on the PSQI (p=0.01), and the TAS-20 (p=0.02). Patients with FM also scored significantly higher in all specific domains of PSQI and TAS-20.

Discussion: The present data were in accordance with literature, disclosing a worse performance of patients with FM on pain impact, sleep complains and more presence of alexithymia.

Conclusion: Studies have disclosed the presence of important and frequently underdiagnosed symptoms beyond pain complaints in FM, such as sleep complaints and alexithymia, and a better knowledge of such disturbances might improve FM patients' approach and treatment.

Keywords: Alexithymia; Alexitimia; Fibromialgia; Fibromyalgia; Pittsburgh Sleep Quality Index; Qualidade de vida; Quality of life; Queixas de sono; Sleep complaints; Toronto Alexithymia Scale.

MeSH terms

  • Adult
  • Affective Symptoms / diagnosis
  • Affective Symptoms / etiology*
  • Brazil
  • Female
  • Fibromyalgia / complications*
  • Fibromyalgia / therapy
  • Follow-Up Studies
  • Humans
  • Male
  • Pain / etiology*
  • Pain Measurement
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / etiology*
  • Surveys and Questionnaires
  • Tertiary Care Centers