CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(09): 556-560
DOI: 10.1590/0004-282X20200082
ARTICLE

Effects of Comorbid Fibromyalgia Syndrome on activities of daily living in multiple sclerosis patients

Efectos del Síndrome de Fibromialgia Comórbido en actividades cotidianas en pacientes con esclerosis múltiple
1   Kayseri Training and Research Hospital, Department of Neurology, Kayseri, Turkey.
› Author Affiliations

ABSTRACT

Objective: To investigate the frequency of Comorbid Fibromyalgia Syndrome and its effects on quality of life and activities of daily living without any known psychiatric problem (schizophrenia or bipolar disorder) or severe disability, other than depression, in patients with multiple sclerosis, which is known to be a chronic disease in young adults. Methods: The study included 103 patients diagnosed with multiple sclerosis, following McDonald criteria, who had relapsing remitting disease. The Fibromyalgia Impact Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Fatigue Severity Scale, and Multiple Sclerosis Quality of Life-54 were applied for all patients. Results were analyzed using statistical methods. Results: Mean age was 35.04±8.72 years in the study population. The Expanded Disability Status Scale (EDSS) score was 2.21±0.93. Comorbid Fibromyalgia Syndrome was detected in 20 patients (19.4%). The mean score of Multiple Sclerosis Quality of Life-54 was found to be significantly higher in multiple sclerosis patients with Comorbid Fibromyalgia Syndrome when compared to those without it (34.80±9.14 versus 71.67±13.95; p<0.05). Conclusion: These results indicate that increased frequency of Comorbid Fibromyalgia Syndrome in multiple sclerosis causes worsening in activities of daily living and quality of life, delayed diagnosis, disability progression, and increased admission rates. Questioning and appropriately managing Comorbid Fibromyalgia Syndrome in clinical practice are important to improve the quality of life in multiple sclerosis patients.

RESUMEN

Objetivo: Investigar la frecuencia del Síndrome de Fibromialgia Comórbido y sus efectos sobre la calidad de vida y las actividades cotidianas sin problemas psiquiátricos conocidos o discapacidad grave en pacientes con esclerosis múltiple, que se conoce como una enfermedad crónica en adultos jóvenes. Métodos: El estudio incluyó a 103 pacientes diagnosticados con esclerosis múltiple, según los criterios de McDonald, que tenían enfermedad remitente recurrente. En todos los pacientes se completaron: el Cuestionario de Impacto de Fibromialgia, el Inventario de Ansiedad de Beck, el Inventario de Depresión de Beck, el Índice de Calidad del Sueño de Pittsburgh, la Escala de Gravedad de Fatiga y la Calidad de Vida de la Esclerosis Múltiple-54. Los resultados se analizaron mediante métodos estadísticos. Resultados: La edad media fue de 35,04±8,72 años en la población de estudio. La puntuación de la Expanded Disability Status Scale (EDSS) fue de 2,21±0,93. Se detectó el Síndrome de Fibromialgia Comórbido en 20 pacientes (19,4%). Se encontró que la puntuación media de la Calidad de Vida de la Esclerosis Múltiple-54 era significativamente más alta en pacientes de esclerosis múltiple con Síndrome de Fibromialgia Comórbido en comparación con aquellos sin él (34,80±9,14 versus 71,67±13,95; p<0,05). Conclusión: Esos resultados indican que el aumento de la frecuencia del Síndrome de Fibromialgia Comórbido en la esclerosis múltiple provoca empeoramiento de las actividades cotidianas y la calidad de vida, diagnóstico tardío, progresión de la discapacidad y mayores tasas de admisión. Cuestionar y manejar adecuadamente el Síndrome de Fibromialgia Comórbido en la práctica clínica son importantes para mejorar la calidad de vida en pacientes con esclerosis múltiple.



Publication History

Received: 08 April 2020

Accepted: 29 April 2020

Article published online:
13 June 2023

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  • References

  • 1 Confavreux C, Vukusic S, Moreau T, Adeleine P. Relapses and progression of disability in multiple sclerosis. N Engl J Med. 2000 Nov;343(20):1430-38. https://doi.org/10.1056/nejm200011163432001
  • 2 Benito-León J, Morales JM, Rivera-Navarro J. Health-related quality of life and its relationship to cognitive and emotional functioning in multiple sclerosis patients. Eur J Neurol. 2002 Sep;9(5):497-502. https://doi.org/10.1046/j.1468-1331.2002.00450.x
  • 3 Marrie RA, Yu N, Blanchard JF, Leung S, Elliott L. The rising prevalence and changing age distribution of multiple sclerosis in Manitoba. Neurology. 2010 Feb;74(6):465-71. https://doi.org/10.1212/WNL.0b013e3181cf6ec0
  • 4 Fromont A, Binquet C, Rollot F, Despalins R, Weill A, Clerc L, et al. Comorbidities at multiple sclerosis diagnosis. J Neurol. 2013 Oct;260(10):2629-37. https://doi.org/10.1007/s00415-013-7041-9
  • 5 Alschuler KN, Jensen MP, Ehde DM. The association of depression with pain-related treatment utilization in patients with multiple sclerosis. Pain Med. 2012 Dec;13(12):1648-57. https://doi.org/10.1111/j.1526-4637.2012.01513.x
  • 6 Desmeules JA, Cedraschi C, Rapiti E, Baumgartner E, Finckh A, Cohen P, et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum. 2003 May;48(5):1420-9. https://doi.org/10.1002/art.10893
  • 7 Thormann A, Sørensen PS, Koch-Henriksen N, Laursen B, Magyari M. Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality. Neurology. 2017 Oct;89(16):1668-75. https://doi.org/10.1212/wnl.20200082202000824508
  • 8 Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011 Feb;69(2):292-302. https://doi.org/10.1002/ana.22366
  • 9 Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expand ed disability status scale (EDSS). Neurology. 1983 Nov;33(11):1444-52. https://doi.org/10.1212/wnl.33.11.1444
  • 10 Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016 Dec;46(3):319-29. https://doi.org/10.1016/j.semarthrit.2016.08.012
  • 11 Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol. Sep-Oct 2005;23(5 Suppl 39):S154-62.
  • 12 Tabrizi FM, Radfar M. Fatigue, sleep quality, and disability in relation to quality of life in multiple sclerosis. Int J MS Care. 2015 Nov-Dec;17(6):268-74. https://doi.org/10.7224/1537-2073.2014-046 .
  • 13 Heiskanen S, Meriläinen P, Pietilä AM. Health-related quality of life-testing the reliability of the MSQOL-54 instrument among MS patients. Scand J Caring Sci. 2007 Jun;21(2):199-206. https://doi.org/10.1111/j.1471-6712.2007.00456.x
  • 14 Buysse DJ, Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4
  • 15 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988 Dec;56(6):893-7. https://doi.org/10.1037//0022-006x.56.6.893
  • 16 Kaynak H, Altintaş A, Kaynak D, Uyanik O, Saip S, Ağaoğlu J, et al. Fatigue and sleep disturbance in mul tiple sclerosis. Eur J Neurol. 2006 Dec;13(12):1333-9. https://doi.org/10.1111/j.1468-1331.2006.01499.x
  • 17 Smarr KL, Keefer AL. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S454-66. https://doi.org/10.1002/acr.20556
  • 18 Kwiatek R. Treatment of fibromyalgia. Aust Prescr. 2017 Oct;40(5):179-83. https://doi.org/10.18773/austprescr.2017.056
  • 19 Marrie RA, Patten SB, Tremlett H, Wolfson C, Warren S, Svenson LW, et al. Sex differences in comorbidity at diagnosis of multiple sclerosis: a population-based study. Neurology. 2016 Apr5;86(14):1279-86. https://doi.org/10.1212/WNL.20200082202000822481
  • 20 Clemenzi A, Pompa A, Casillo P, Pace L, Troisi E, Catani S, et al. Chronic pain in multiple sclerosis: Is there also fibromyalgia? An observational study. Med Sci Monit. 2014 May;20:758-66. https://doi.org/10.12659/MSM.89000
  • 21 Davis JA, Robinson RL, Le TK, Xie J. Incidence and impact of pain conditions and comorbid illnesses. J Pain Res. 2011;4:331-45. https://doi.org/10.2147/JPR.S24170
  • 22 Fiest KM, Fisk JD, Patten SB, Tremlett H, Wolfson C, Warren S, et al. Comorbidity is associated with pain-related activity limitations in multiple sclerosis. Mult Scler Relat Disord. 2015 Sep;4(5):470-76. https://doi.org/10.1016/j.msard.2015.07.014
  • 23 Marrie RA, Horwitz RI, Cutter G, Tyry T, Campagnolo D, Vollmer T. Comorbidity delays diagnosis and increases disability at diagnosis in MS. Neurology. 2009 Jan;72(2):117-24. https://doi.org/10.1212/01.wnl.0000333252.78173.5f
  • 24 Sadovnick AD, Remick RA, Allen J, Swartz E, Yee IM, Eisen K, et al. Depression and multiple sclerosis. Neurology. 1996 Mar;46(3):628-32. https://doi.org/10.1212/wnl.46.3.628
  • 25 Stenager E, Knudsen L, Jensen K. Multiple sclerosis: correlation of anxiety, physical impairment and cognitive dysfunction. Ital J Neurol Sci. 1994;15(2):97-101. https://doi.org/10.1007/BF02340120
  • 26 Edwards NC, Munsell M, Menzin J, Phillips AL. Comorbidity in US patients with multiple sclerosis. Patient Relat Outcome Meas. 2018;9:97-102. https://doi.org/10.2147/PROM.S148387
  • 27 Kroencke DC, Lynch SG, Denney DR. Fatigue in multiple sclerosis: relationship to depression, disability, and disease pattern. Mult Scler. 2000 Apr;6(2):131-6. https://doi.org/10.1177/135245850000600213
  • 28 Merlino G, Fratticci L, Lenchig C, Valente M, Cargnelutti D, Picello M, et al. Prevalence of’poor sleep’among patients with multiple sclerosis: an independent predictor of mental and physical status. Sleep Med. 2009 Jan;10(1):26-34. https://doi.org/10.1016/j.sleep.2007.11.004
  • 29 Figved N, Klevan G, Myhr KM, Glad S, Nyland H, Larsen JP, et al. Neuropsychiatric symptoms in patients with multiple sclerosis. Acta Psychiatr Scand. 2005 Dec;112(6):463-8. https://doi.org/10.1111/j.1600-0447.2005.00624.x