Mental health and well-being during the COVID-19 pandemic: stress vulnerability, resilience and mood disturbances in fibromyalgia and rheumatoid arthritis

Abstract

Objective. The COVID-19 pandemic severely increased the stress levels in the population. The aim of present study was to investigate the impact of the lockdown measures on emotional well-being and disease activity in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) through a telemedicine approach.Methods. An on-line survey, including demographic characteristics, disease-activity and psychometric scales (Stress-related Vulnerability Scale, Resiliency scale), Zung Anxiety and Depression Self-assessment Scale), was anonymously administered to FM, RA and healthy controls (HC). Disease activities were compared to the pre-lockdown cohort referring to our centre. Results. Levels of anxiety and depression worthy of psychiatric attention were documented in 36.7% of FM, 14.6% of RA, 12.5% of HC and in 50% of FM, 17.1% of RA, 15% of HC, respectively. HC featured the highest stress scores, followed FM and then RA. RA showed higher resiliency than FM. Both anxiety and depression scores were significantly higher in FM than RA and HC. Disease severity was higher in RA patients and lower in FM patients when compared to the respective historical cohorts. Conclusion. Lockdown significantlyaffected the emotional well-being and disease activity of patients suffering from rheumatic diseases. While HC showed a higher vulnerability to stress, RA patients showed a greater resilience compared to both HC and to FM patients, especially. Emotional disturbances are greater in patients with RDs and in particular with FM. The use of a telemedicine approach to screen for severe symptoms represents a useful addition to the overall management of rheumatic patients.

A better but persistently low health status in women with fibromyalgia during the COVID-19 pandemic: a repeated cross-sectional data analysis

“…Obtaining repeated data from the same people at similar periods in the year would have yielded insight into how many people deteriorated and ameliorated. However, our results are not inconsistent with most studies measuring intra-individual changes in smaller samples of people with fibromyalgia [ 10 – 12 ]. We did not have perfect norm data, because the norm group is from 25 years ago and included 35% men, which may have yielded somewhat lower scores in our sample of women with fibromyalgia.…”

“…There were earlier studies indicating that mental and physical health, such as reflected in fibromyalgia severity scores, was not worse [ 8 , 10 , 11 ] and perhaps even better [ 12 ] during than before the pandemic. Only one study observed a lower health during the pandemic [ 9 ].…”

“…Although during the pandemic the severity of fibromyalgia was also observed to worsen in a considerable part of the participants [ 7 , 10 – 12 ], from a theoretical point of view it is unexpected that, on a group level, there was no mean change or even a positive change. This suggests that the negative impact of the COVID-19 pandemic on people with fibromyalgia is weaker than assumed.…”

“…In a qualitative study, next to exacerbation of pain and fatigue, patients also reported better quality of life [ 7 ]. In longitudinal studies [ 8 – 11 ] with assessments before and during the pandemic or comparing a sample during the pandemic with a historic pre-pandemic sample [ 12 ], self-reported health of patients with fibromyalgia did not differ before, during or after the lockdown [ 8 , 10 , 11 ]. In one study, worse health during the lockdown [ 9 ] was indicated, but in another study, health improved [ 12 ].…”

“…In longitudinal studies [ 8 – 11 ] with assessments before and during the pandemic or comparing a sample during the pandemic with a historic pre-pandemic sample [ 12 ], self-reported health of patients with fibromyalgia did not differ before, during or after the lockdown [ 8 , 10 , 11 ]. In one study, worse health during the lockdown [ 9 ] was indicated, but in another study, health improved [ 12 ]. Also, in our study including people with fibromyalgia among other groups with persistent physical symptoms, somatic symptom severity was suggested to be lower during than before the pandemic [ 13 ].…”