Background/Purpose: Only one-third of FM patients obtain benefits after receiving one of the available therapy modalities. Insights into the heterogeneous picture of FM might improve therapy effectiveness. The present study aimed to examine 1) whether it is possible to differentiate between clinically meaningful profiles (subgroups) and 2) whether these profiles differ in terms of FM severity.

Methods: The al-Ándalus project allowed us to perform a comprehensive cross-sectional approach including assessments of physical, psychological, and cognitive adjustment in a total of 510 FM patients, who met either the 1990 or the modified 2010 ACR FM criteria. Measurements included objective (e.g., neuropsychological tests) and subjective data (i.e., questionnaires). Analyses of these assessments involved a two-step approach of exploratory factor analysis and cluster analysis.

Results: The first (factor analyses) step yielded 8 factors; 3 including objective measures (declarative memory, performed physical fitness, and active lifestyle) and 5 including subjective measures (fatigue, psychological distress, catastrophizing, resilience, and subjective physical fitness). In cluster analyses, the combination of these 8 factor scores yielded 5 profiles. An Adapted profile (n=88, 17%) showing low psychological distress, catastrophizing, and physical fatigue as well as high resilience and (both objective and subjective) physical fitness. A Fit profile (n=96, 19%) characterized by an active lifestyle and enhanced objective physical fitness. A Positive profile (n=116, 23%) in which catastrophizing was low. An Unfit profile (n=91, 18%) characterized by poor subjective physical fitness. A Maladapted profile (n=119, 23%) characterized by poor resilience and (objective and subjective) physical fitness as well as increased levels of psychological distress, catastrophizing, and physical fatigue. One-way analyses of variance showed that the mean score (standard deviation) of FM severity at the Revised FM Impact Questionnaire was 47 (13), 60 (15), 65 (13), 66 (14), and 79 (11) for Adapted, Fit, Positive, Unfit, and Maladapted profiles, respectively. After Student-Newman-Keuls posthoc tests, significant differences emerged between all the profiles; the only one exception was between Positive and Unfit groups.

Conclusion: Our study suggested the existence of 5 adjustment profiles that were differentially associated with FM severity. Future research using longitudinal designs should examine whether these profiles are associated with the prognosis of FM and the effectiveness of interventions, which would enhance the development of interventions customized to the adjustment profiles of FM patients. Funding: The Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639, I+D+i DEP2013-40908-R, BES-2014-067612, and BES-2011-047133) and Education (FPU2014/02518).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/adjustment-profiles-comprising-objective-and-subjective-measures-in-fibromyalgia-patients/