The effects of COVID-19 fear and anxiety on symptom severity, sleep quality, and mood in patients with fibromyalgia: a pilot study

Abstract

Background During the COVID-19 pandemic, individuals faced psychological stress caused by fear and anxiety due to the high transmission and mortality rate of the disease, the social isolation, economic problems, and difficulties in reaching health services. Fibromyalgia (FM) is a chronic centralized pain sensitivity disorder. Psychological, physical and/or autoimmune stressors were found to increase FM symptoms. This pilot study aimed to evaluate the COVID-19 fear and anxiety level, and to examine their effect on disease severity, sleep quality, and mood in FM patients compared to control group. Methods This pilot study conducted as a cross-sectional study, and included 62 participants. Participants were divided into two groups: FM patient group (n = 31) and control group (n = 31). Symptom severity, sleep quality, and mood were determined using the Revised Fibromyalgia Impact Questionnaire (FIQR), Pitsburg Sleep Quality Index (PSQI), and Hospital Anxiety Depression Scale (HADS), respectively. In order to evaluate the level of COVID-19 fear and anxiety, the Fear of COVID-19 Scale (FCV-19S) and Coronavirus Anxiety Scale (CAS) were used compared to control group. Results FIQR, PSQI, HAD-A, HAD-D, FCV-19S and CAS scores were significantly higher in the FM group (p = 0.01). A positive significant correlation was found between FCV-19S and CAS results and FIQR, PSQI, and HAD-anx results in FM patients (p < 0.05). Conclusion This pilot study showed that, the individuals with FM can be more affected by psychological stress, and this situation negatively affects the symptom severity, sleep quality, and mood in FM patients, so these patients should be closely monitored in terms of psychological stressors and their effects during pandemics. More studies with more participants are necessary to describe the challenges lived by fibromyalgia population.

Psychological Consequences of Coronavirus 2019 Pandemic in Fibromyalgia Patients: A Systematic Review Study

“…It can be stated that patients with fibromyalgia are known to be vulnerable to COVID-19 because they have a weaker immune system (20). This has caused many patients to suffer from severe fear and anxiety about COVID-19 and limit their social interactions (8).…”

“…Pain is the most characteristic symptom of fibromyalgia and affects many aspects of a person's life and is associated with disruption of daily and normal activities, changes in the ability to work, inhibition of adequate sleep, and dissatisfaction with life (12). Pain and a feeling of uncontrollability, when accompanied by catastrophic thoughts, cause depression, and the more depressed the patient's mood, the lower the pain tolerance threshold (20)(21)(22)(23). Various studies indicate the high prevalence of mental disorders in patients with fibromyalgia, and depression is one of the most common psychological comorbidities in such patients (11).…”

“…During the COVID-19 pandemic, in addition to fibromyalgia, a variety of secondary factors such as age, female gender, low level of education, poor sleep quality, marital status, financial status, and loneliness affected pa-tients' mental health (17)(18)(19)(20)(21)(22)(23)(24)(25). For this reason, in addition to the mental health of fibromyalgia patients, it is necessary to pay further attention to the individual differences and lifestyle of these patients to promote the psychological health of fibromyalgia patients during the COVID-19 pandemic (14)(15)(16).…”

“…High levels of fatigue and anxiety resulting from quarantine conditions significantly increase the need for extreme self-care in fibromyalgia patients, but due to the lack of a definitive treatment for COVID-19, the person might fail to respond to this need (20,21). In this regard, Salaffi et al (22), in a study, investigated the effects of the prevalence of COVID-19 on mental health and quality of life of fibromyalgia patients.…”

The positive side of the coin: Sars-Cov-2 pandemic has taught us how much Telemedicine is useful as standard of care procedure in real life

“…In the literature, the effects of the lockdown on RMDs patients are now documented [1][2][3][4]. In fact, the restrictions significantly affected the emotional well-being and favoured the disease relapse [5].…”