Clinical profiles in fibromyalgia patients of the community mental health center: a predictive index of psychopathological severity.

INTRODUCTION: In recent years we have seen an increasing demand for mental health care in patients with fibromyalgia and psychiatric symptoms, although it is not clear if the symptoms are primary or secondary to the presence of the syndrome. This fact has led mental health providers to think that there would be some psychological factors influencing the vulnerability of suffering this painful syndrome, because its etiology is quite non-specific. Bradley et al. (1978) identified different psychopathological profiles within chronic pain syndromes with the MMPI, which were subsequently adapted by Yunus et al. (1991) for fibromyalgia. This present work studied the clinical profile in patients with fibromyalgia. SAMPLE: 75 patients with fibromyalgia from the community mental health center and 55 healthy subjects. Tools: STAI-E/R, BDI, MMPI-2, MMPI-2 personality disorders, MMPI-2 PSY-5. STATISTICAL ANALYSIS: descriptive statistics and mean comparison (Student's t test). Confirmatory cluster analysis. Discriminative analysis of subgroups. RESULTS: Two different patterns were obtained: group A (32 %) with a typical chronic pain profile (CP) and group B (68 %) with a psychological maladjustment profile (PM). With the discriminative analysis, we obtained the coefficients of the discriminative canonical functions that maximize the differences between both groups. CONCLUSIONS: We confirmed Bradley's classification, obtaining two different psychopathological patterns in the fibromyalgia syndrome sample we studied. We obtained an index of psychopathological profile in fibromyalgia, which would form a new scale, from MMPI-2 for discriminating psychopathological severity in fibromyalgia.

Perfiles clínicos en pacientes con fibromialgia que acuden a un centro de salud mental: obtención de un índice predictivo de gravedad psicopatológica / Clinical profiles in fibromyalgia patients of the community mental health center: a predictive index of psychopathological severity

Introducción. En los últimos años se ha visto incrementada la demanda asistencial en salud mental de pacientes que presentan fibromialgia y sintomatología psiquiátrica, y no queda claro en la mayoría de los casos si esta patología es primaria o secundaria a la aparición del síndrome. Esto ha hecho plantearse a los profesionales de la salud mental la influencia de distintos factores psicológicos de vulnerabilidad a padecer este síndrome doloroso dada la inespecificidad a nivel etiológico. Bradley et al. (1978) identificaron a través del MMPI distintos perfiles psicopatológicos dentro de síndromes con dolor crónico que posteriormente fueron adaptados por Yunus et al. (1991) para la fibromialgia. En el presente trabajo se estudian los perfiles clínicos en pacientes con fibromialgia. Método. Muestra: 75 pacientes derivados al centro de salud mental que presentan fibromialgia; 55 sujetos control sanos. Instrumentos: STAI-E/R; BDI, MMPI-2, MMPI-2 trastornos de la personalidad, MMPI-2 PSY-5. Análisis estadísticos: estadísticos descriptivos y comparación de medias (t de Student). Análisis de clúster confirmatorio. Análisis discriminante de los subgrupos. Resultados. Se obtienen dos patrones diferenciales: grupo A (32 %) con un perfil típico del dolor crónico (DC) y grupo B (68 %) con un perfil de desajuste psicológico (DP). Mediante el análisis discriminante obtuvimos los coeficientes de las funciones canónicas discriminantes que maximizan las diferencias entre los dos grupos. Conclusiones. Se confirma la clasificación de Bradley obteniendo dos patrones psicopatológicos diferenciales en la muestra de síndrome de fibromialgia estudiada. Se obtiene un índice de perfil psicopatológico en fibromialgia que configura una nueva escala a partir del MMPI-2, que discrimina gravedad psicopatológica en la fibromialgia

Introduction. In recent years we have seen an increasing demand for mental health care in patients with fibromyalgia and psychiatric symptoms, although it is not clear if the symptoms are primary or secondary to the presence of the syndrome. This fact has led mental health providers to think that there would be some psychological factors influencing the vulnerability of suffering this painful syndrome, because its etiology is quite non-specific. Bradley et al. (1978) identified different psychopathological profiles within chronic pain syndromes with the MMPI, which were subsequently adapted by Yunus et al. (1991) for fibromyalgia. This present work studied the clinical profile in patients with fibromyalgia. Method. Sample: 75 patients with fibromyalgia from the community mental health center and 55 healthy subjects. Tools: STAI-E/R, BDI, MMPI-2, MMPI-2 personality disorders, MMPI-2 PSY-5. Statistical analysis: descriptive statistics and mean comparison (Student's t test). Confirmatory cluster analysis. Discriminative analysis of subgroups. Results. Two different patterns were obtained: group A (32 %) with a typical chronic pain profile (CP) and group B (68 %) with a psychological maladjustment profile (PM). With the discriminative analysis, we obtained the coefficients of the discriminative canonical functions that maximize the differences between both groups. Conclusions. We confirmed Bradley's classification, obtaining two different psychopathological patterns in the fibromyalgia syndrome sample we studied. We obtained an index of psychopathological profile in fibromyalgia, which would form a new scale, from MMPI-2 for discriminating psychopathological severity in fibromyalgia