The Clinical and Psychosocial Phenotype of Fibromyalgia Syndrome in Female Patients: A Comprehensive Review of Etiology, Burden, and Management
Abstract
Background: Fibromyalgia Syndrome (FMS) is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties, predominantly affecting women. Given its complex etiology and significant comorbidity profile, understanding the specific clinical and psychosocial phenotype in female patients is essential for optimized management and resource allocation.
Methods: This comprehensive review synthesizes data from peer-reviewed literature (References 1-23) focusing on the demographics, core clinical symptoms, psychological distress (e.g., anxiety, depression), functional impairment, and socioeconomic burden of FMS in female cohorts. The analysis prioritizes studies utilizing standardized assessment tools (e.g., FIQ, WHOQOL) and current diagnostic criteria.
Results: Findings confirm the high prevalence of co-morbid psychological disorders, particularly anxiety and depression, which significantly correlate with higher pain severity and diminished health-related quality of life (HRQoL). Functional disability is substantial, leading to high direct and indirect healthcare costs. The female phenotype is associated with specific symptom clusters that often delay diagnosis and complicate treatment.
Conclusion: FMS in female patients represents a complex, multi-dimensional burden that extends beyond physical pain. A deeper understanding of this specific phenotype is critical to developing personalized, multidisciplinary interventions that simultaneously target central sensitization, pain amplification, and associated psychological distress. Further research is required to address current diagnostic heterogeneities.
Keywords
Female Phenotype, Central Sensitization, Chronic Pain, Psychosocial Burden, Comorbidity, Fibromyalgia Syndrome (FMS)How to Cite
References
Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012;2012:426130. doi: 10.1155/2012/426130.
Clauw DJ. Fibromyalgia: an overview. Am J Med. 2009;122(12 Suppl):S3-S13. doi: 10.1016/j.amjmed.2009.09.006.
Pagano T, Matsutani LA, Ferreira EA, Marques AP, Pereira CA. Assessment of anxiety and quality of life in fibromyalgia patients. Sao Paulo Med J. 2004;122(6):252-8. doi: 10.1590/s1516-31802004000600005.
Price DD, Staud R. Neurobiology of fibromyalgia syndrome. J Rheumatol Suppl. 2005;75:22-8. PMID: 16078357.
Petersel DL, Dror V, Cheung R. Central amplification and fibromyalgia: disorder of pain processing. J Neurosci Res.2011;89(1):29-34. doi: 10.1002/jnr.22512.
Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, et al. [Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines]. Z Psychosom Med Psychother. 2013;59(2):132-52. doi: 10.13109/zptm.2013.59.2.132.
Abeles AM, Pillinger MH, Solitar BM, Abeles M. Narrative review: the pathophysiology of fibromyalgia. Ann Intern Med. 2007;146(10):726-34. doi: 10.7326/0003-4819-146-10-200705150-00006.
Epstein SA, Kay G, Clauw D, Heaton R, Klein D, Krupp L, et al. Psychiatric disorders in patients with fibromyalgia. A multicenter investigation. Psychosomatics. 1999;40(1):57-63. doi: 10.1016/s0033-3182(99)71272-7.
The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9. doi: 10.1016/0277-9536(95)00112-k.
Campos RP, Vázquez MIR. Health-related quality of life in women with fibromyalgia: clinical and psychological factors associated. Clin Rheumatol. 2012;31:347-55. doi: 10.1007/s10067-011-1870-7.
Sezgin Özcan D, Aras M, Köseoğlu BF, Şentürk Güven Ş. Quality of life and associated conditions in women with fibromyalgia syndrome. Osteoporoz. 2013;19:0-0. doi: 10.4274/tod.38258
Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken).2013;65(5):786-92. doi: 10.1002/acr.21896.
Berger A, Dukes E, Martin S, Edelsberg J, Oster G. Characteristics and healthcare costs of patients with fibromyalgia syndrome. Int J Clin Pract. 2007;61(9):1498-508. doi: 10.1111/j.1742-1241.2007.01480.x.
Lamotte M, Maugars Y, Le Lay K, Taïeb C. Health economic evaluation of outpatient management of fibromyalgia patients and the costs avoided by diagnosing fibromyalgia in France. Clin Exp Rheumatol. 2010;28(6 Suppl):S64-S70.
Grodman I, Buskila D, Arnson Y, Altaman A, Amital D, Amital H. Understanding fibromyalgia and its resultant disability. IMAJ-Israel Med Assoc J. 2011;13(12):769. PMID: 22332450.
D'Onghia M, Ciaffi J, Ruscitti P, Cipriani P, Giacomelli R, Ablin JN, Ursini F. The economic burden of fibromyalgia: A systematic literature review. Semin Arthritis Rheum. 2022;56:152060. doi: 10.1016/j.semarthrit.2022.152060.
Nguyen VC, Park J. Relationships between demographic factors and chronic conditions with disease severities. Int J Environ Res Public Health. 2021;18(21):11469. doi: 10.3390/ijerph182111469.
Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000;20(1):9-12. doi: 10.1007/s002960000077.
Bennett RM, Friend R, Marcus D, Bernstein C, Han BK, Yachoui R, et al. Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria. Arthritis Care Re1s (Hoboken). 2014;66:1364-73. doi: 10.1002/acr.22301.
Dernek B. Fibromiyalji Sendromu Hastalarının İşlevsellik, Yetiyitimi ve Sağlığın Uluslararası Sınıflandırılması ICF Kapsamında Değerlendirilmesi: Pilot Çalışma. Acıbadem Univ Health Sci J. 2020;1:160-6.
Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38:19-28.
Cacace E, Ruggiero V, Anedda C, Denotti A, Minerba L, Perpignano G. Quality of life and associated clinical distress in fibromyalgia. Reumatismo. 2006/09/30;58. doi: 10.4081/reumatismo.2006.226.
Aparicio VA, Ortega FB, Carbonell-Baeza A, Cuevas AM, Delgado-Fernández M, Jonatan R. Anxiety, depression and fibromyalgia pain and severity. Behav Psychol. 2013;21:381
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