Fibromyalji Sendromu Hastalarının Ağrı İnançları ile Psikiyatrik Belirtileri Arasındaki İlişki

Year 2019, Volume: 21 Issue: 3, 238 - 242, 30.12.2019

Arzu Yüksel , Hatice Tambağ , Ahmet Karakoyun

https://doi.org/10.18678/dtfd.641962

Cited By: 2

Abstract

Amaç: Bu çalışma fibromiyalji sendromlu (FMS) hastaların ağrı inançları ile psikiyatrik belirtileri arasındaki ilişkiyi incelemek amacıyla yapılmıştır.

Gereç ve Yöntemler: Kesitsel türdeki bu çalışma, Aksaray Üniversitesi Eğitim ve Araştırma Hastanesinin Fizik Tedavi ve Rehabilitasyon polikliniğinde Ağustos 2018 ve Ocak 2019 tarihleri arasında FMS tanısı almış olan 145 hasta ile yapılmıştır. Hastalara yazarlar tarafından hazırlanmış olan sosyodemografik veri formu, Ağrı İnançları Ölçeği (AİÖ), Depresyon Anksiyete Stres Ölçeği (DASÖ) ve Vizüel Analog Skala (VAS) uygulanmıştır.

Bulgular: FMS hastalarının yaş ortalamaları 35,42±9,10 yıl olup %57,9’u (n=84) kadın, %70,3’ü (n=102) evli ve %95,9’u (n=139) çekirdek ailede yaşamaktadır. Hastaların %46,9’u (n=68) VAS’a göre ağrıyı 9-10 (ortalama: 8,12±1,29) şiddetinde algıladığını bildirmiştir. Organik inançlar puan ortalaması 4,87±0,77 ve psikolojik inançlar puan ortalaması ise 5,17±0,52’dir. Depresyon (%62,8) ve anksiyete (%33,1) düzeylerinin çok ileri düzeyde olduğu, stres (%45,5) düzeylerinin ise ileri düzeyde olduğu bulunmuştur. DASÖ toplam ve alt ölçeklerden, depresyon, anksiyete ve stres ile hem organik inançlar hem de psikolojik inançlar arasında istatistiksel olarak anlamlı pozitif korelasyon saptanmıştır (tüm p değerleri <0,001).

Sonuç: Hastalarının ağrı inançları ve ağrı algılama düzeylerinin yüksek olduğu, aynı zamanda eşlik eden psikiyatrik belirti oranının da yüksek olduğu tespit edilmiştir. Hastaların ağrı inançları artarken depresyon, anksiyete ve stres düzeyleri de artmaktadır. FMS hastalarında tedaviye verilen yanıtı güçlendirebilmek için bütüncül yaklaşımların kullanılması önemlidir.

Keywords

Fibromiyalji sendromu, ağrı inançları, psikiyatrik belirtiler

The Relationship between Pain Beliefs and Psychiatric Symptoms of Patients with Fibromyalgia Syndrome

Abstract

Aim: This study was conducted to examine the relationship between the pain beliefs and psychiatric symptoms of the patients with fibromyalgia syndrome (FMS).

Material and Methods: This cross-sectional study was conducted with 145 patients diagnosed with FMS between August 2018 and January 2019 in the Physical Therapy and Rehabilitation polyclinic of Aksaray University Training and Research Hospital. The sociodemographic data form prepared by authors, Pain Beliefs Scale (PBS), Depression Anxiety Stress Scale (DASS) and Visual Analogue Scale (VAS) were applied to the patients.

Results: Mean age of FMS patients is 35.42±9.10 years, 57.9% (n=84) are female, 70.3% (n=102) are married and 95.9% (n=139) live in nuclear families. Of the patients, 46.9% (n=68) were reported that they perceived the pain at the severity of 9-10 (mean: 8.12±1.29) according to VAS. Mean score of organic beliefs was 4.87±0.77, and mean score of psychological beliefs was 5.17±0.52. It was found that depression (62.8%) and anxiety (33.1%) levels were very advanced, and stress (45.5%) levels were advanced. A statistically significant positive correlation was detected between the DASS total and the subscales of depression, anxiety and stress and both organic beliefs and psychological beliefs (all p values <0.001).

Conclusion: The patients' pain beliefs and pain perception levels were found high and the rate of accompanying psychiatric symptoms was also high. While the patients' pain beliefs increase, their depression, anxiety and stress levels also increase. It is important to use holistic approaches to strengthen the response given to treatment in patients with FMS.

Keywords

Fibromyalgia syndrome, pain beliefs, psychiatric symptoms

References

• Wolfe F, Walitt B, Perrot S, Rasker JJ, Häuser W. Fibromyalgia diagnosis and biased assessment: sex, prevalence and bias. PLoS One. 2018;13(9):e0203755.
• Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010;62(5):600-10.
• Kösehasanoğulları M, Yılmaz N. Fibromyalgia syndrome and neuropathic pain. Aegean J Med Sci. 2018;1(1):26-31.
• Topbaş M, Çakırbay H, Güleç H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol. 2005;34(2):140-4.
• Galvez-Sánchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag. 2019;12:117-27.
• Ataoğlu S, Özçetin A, Ataoğlu A, İçmeli C, Makarç S, Yağlı M. The relationship between pain intensity, anxiety and depression in patients with fibromyalgia and rheumatoid arthritis. Anadolu Psikiyatri Derg. 2002;3(4):223-6.
• Edwards CL, Fillingim RB, Keefe F. Race, ethnicity and pain. Pain. 2001;94(2):133-7.
• Eti Aslan F, Badır A. Reality about pain control: The knowledge and beliefs of nurses on the nature, assessment and management of pain. Agri. 2005;17(2):44-51.
• Richards J, Hubbert AO. Experiences of expert nurses in caring for patients with postoperative pain. Pain Manag Nurs. 2007;8(1):17-24.
• Koçoğlu D, Özdemir L. The relation between pain and pain beliefs and sociodemographic-economic characteristics in an adult population. Agri. 2011;23(2):64-70.
• Babadağ B, Alparslan GB, Güleç S. The relationship between pain beliefs and coping with pain of algology patients’. Pain Manag Nurs. 2015;16(6):910-9.
• Sloan TJ, Gupta R, Zhang W, Walsh DA. Beliefs about the causes and consequences of pain in patients with chronic inflammatory or noninflammatory low back pain and in pain-free individuals. Spine (Phila Pa 1976). 2008;33(9):966-72.
• Berk HÖS, Bahadır G. The experience of chronic pain and pain beliefs. Agri. 2007;19(4):5-15.
• Pons T, Shipton E, Mulder R. The relationship between beliefs about pain and functioning with rheumatologic conditions. Rehabil Res Pract. 2012;2012:206263.
• Aguglia A, Salvi V, Maina G, Rossetto I, Aguglia E. Fibromyalgia syndrome and depressive symptoms: comorbidity and clinical correlates. J Affect Disord. 2011;128(3):262-6.
• Hudson JI, Hudson MS, Pliner LF, Goldenberg DL, Pope HG Jr. Fibromyalgia and major affective disorder: a controlled phenomenology and family history study. Am J Psychiatry. 1985;142(4):441-6.
• Altunören Ö, Orhan FÖ, Nacitarhan V, Özer A, Karaaslan MF, Altunören O. Evaluation of depression, temperament and character profiles in female patients with fibromyalgia syndrome. Arch Neuropsychiatry. 2011;48(1):31-8.
• Evren B, Evren C, Yapıcı A, Güler MH. Severity of pain and relationship with psychiatric symptoms in patients with fibromyalgia. Anadolu Psikiyatri Derg. 2005;6(2):69-74.
• Edwards LC, Pearce SA, Turner-Stokes L, Jones A. The pain beliefs questionnaire: an investigation of beliefs in the causes and consequences of pain. Pain. 1992;51(3):267-72.
• Berk HÖS. The experience of chronic pain and pain beliefs: the Turkish validation study of the pain beliefs questionnaire [PhD Thesis]. İstanbul: İstanbul University Institute of Social Sciences; 2006.
• Walsh DA, Radcliffe JC. Pain beliefs and perceived physical disability of patients with chronic low back pain. Pain. 2002;97(1-2):23-31.
• Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335-43.
• Akın A, Çetin B. The depression anxiety and stress scale (DASS): the study of validity and reliability. Educational Sciences: Theory & Practice. 2007;7(1):241-68.
• Türkyılmaz AK, Kurt EE, Karkucak M, Çapkın E. Sociodemographic characteristics, clinical signs and quality of life in patients with fibromyalgia. Eurasian J Med. 2012;44(2):88-93.
• Kara M, Reşorlu H, Döner D, Güçlü O, Dereköy FS. Evaluation of the relationship between voice disorders and the disease activity in patients with fibromyalgia syndrome. KBB Forum. 2016;15(2):49-55.
• Karadağ A, Canbaş M, Parlak M. The effect of balneotherapy on pain and quality of life in patients with fibromyalgia. Mustafa Kemal Üniv Tıp Derg. 2018;9(35):114-20.
• Özcan DS, Aras M, Köseoğlu BF, Güven ŞŞ. Quality of life and associated conditions in women with fibromyalgia syndrome. Turk J Osteoporos. 2013;19(2):42-7.
• Yıldızeli Topçu S. Relations among pain, pain beliefs, and psychological well-being in patients with chronic pain. Pain Manag Nurs. 2018;19(6):637-44.
• Dogan N, Goris S. The effect of pain levels and pain beliefs of elderly people living in nursing home on quality of life. Int J Caring Sci. 2018;11(2):947-54.
• Chang MH, Hsu JW, Huang KL, Su TP, Bai YM, Li CT, et al. Bidirectional association between depression and fibromyalgia syndrome: a nationwide longitudinal study. J Pain. 2015;16(9):895-902.
• Soriano-Maldonado A, Amris K, Ortega FB, Segura-Jiménez V, Estévez-López F, Álvarez-Gallardo IC, et al. Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia. Qual Life Res. 2015;24(12):2951-7.
• Vespa A, Meloni C, Giulietti MV, Ottaviani M, Spatuzzi R, Merico F, et al. Evaluation of depression in women affected by fibromyalgia syndrome. J Depress Anxiety. 2015;4(2):178.
• Zhang Y, Liang D, Jiang R, Ji X, Wang Y, Zhu J, et al. Clinical, psychological features and quality of life of fibromyalgia patients: a cross-sectional study of Chinese sample. Clin Rheumatol. 2018;37(2):527-37.
• Gormsen L, Rosenberg R, Bach FW, Jensen TS. Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. Eur J Pain. 2010;14(2):127.e1-8.