Personality and fibromyalgia syndrome

Background: Fibromyalgia Syndrome (FM) is a Functional Somatic Syndrome characterized by chronic pain, sleep disturbances, fatigue, cognitive changes and mood disorders. While many studies have highlighted high level of psychopathological disorders, the issue of a personality profile specific of FM is still debated. Methods: In this cross-sectional study, a group of 40 FM patients was compared to a group of 40 patients with Rheumatoid Arthritis (RA) and 40 Healthy Controls (HC). Personality Disorders (PD) and Personality Organization (PO) were assessed by means of the Structured Clinical Interview of Personality Disorder (SCID-5-PD) and the Structured Interview of Personality Organization (STIPO), respectively. Results: According to the SCID-5-PD, 32% of FM patients reported a PD, especially a Borderline or an Other Specified Disorders, compared to 7.5% of AR patients and 5% of HC. Regarding the STIPO, 42.5% of FM patients had a borderline PO, compared to 25% of AR patients and 7.5% of HC. In particular, FM patients had high impairments in the STIPO Coping-Rigidity, Primitive Defenses and Object Relations dimensions. Furthermore, the presence of a borderline PO has a statistically significant negative effect on depressive symptoms, global distress indices and somatization dimension of the Self-Report Symptoms Inventory (SCL-90-R), and on the mental component of the health related quality of life (SF-36). Conclusions: Fibromyalgia patients showed a high prevalence of a borderline PO, which negative impact on the psychopathological symptoms. The assessment of PO could be a crucial issue for treatment planning in chronic pain patients, and should further be analysed.