Fibromyalgia as a Heterogeneous Condition: Patient Subgroups Based on Physical Symptoms and Pain-Related Cognitive-Affective Variables

Fibromyalgia (FM) is a chronic condition with a wide range of clinical symptoms, and understanding this diversity will aid in the development of personalized therapies.

The role of several physical symptoms (pain, exhaustion, and poor sleep quality) and cognitive-affective variables related to pain (pain catastrophizing, pain vigilance, self-efficacy in pain management, and pain acceptance) in the configuration of clinical profiles was investigated in this cross-sectional study to better understand the heterogeneity of FM.

An interview and multiple self-report tests were completed by 161 women with FM to investigate physical symptoms, cognitive-affective factors, impairment, and psychopathology.

To establish FM groups a hierarchical cluster analysis was performed. The findings revealed three clusters that differed in the grouping variables, Wilks’ λ = .17, F(14, 304) = 31.50, p < .001, ηp2 = .59. Group 1 (n = 72) was characterized by high physical and psychological affectation, Group 2 (n = 19) by low physical affectation and high pain self-efficacy, and Group 3 (n = 70) by moderate physical affectation and low pain catastrophizing. The external validation of the clusters was confirmed, Wilks’ λ = .72, F(4, 314) = 14.09, p < .001, ηp2 = .15, showing Group 1 the highest levels of FM impact and psychopathological distress.

Therapeutic methods tailored to the individual needs of each subgroup were recommended based on the clinical features of each subgroup. Examining FM profiles may be crucial to a deeper understanding and treatment of this syndrome.

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