SAT0700-HPR PHYSICAL AND PSYCHOLOGICAL DETERMINANTS OF FIBROMYALGIA SEVERITY: A STRUCTURAL EQUATION MODELLING FROM THE AL-ÁNDALUS CROSS-SECTIONAL STUDY
Authors: Fernando Estevez-Lopez, Octavio Luque-Reca, Víctor Segura-Jiménez, Inmaculada C. Alvarez-Gallardo, Alberto Soriano Maldonado, Pedro Acosta-Manzano, Blanca Gavilán Carrera, Joseph Mcveigh, Rinie Geenen, Manuel Delgado-Fernández, Manuel Pulido-Martos
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> In fibromyalgia, the main aim of therapy is to reduce the severity or impact of the disease [1]. The effectiveness of the most commonly used therapies is modest in fibromyalgia. Therefore, identifying modifiable factors associated with lower fibromyalgia severity is a priority as these modifiable factors may be possible therapeutic targets [2-4]. <h3>Objectives:</h3> This study examined the determinants of fibromyalgia severity. <h3>Methods:</h3> In this observational, population-based cross-sectional study, 569 people with fibromyalgia were assessed on resilience, catastrophizing, active lifestyle, declarative memory, subjective fitness, objective fitness, psychological distress, physical fatigue and disease severity. Structural equation modelling estimation was used to analyse the following hypotheses: (i) resilience, catastrophizing and active lifestyle through subjective fitness, objective fitness, psychological distress, and physical fatigue determine fibromyalgia severity; and (ii) these factors are distributed in two core pathways (one physical and one psychological) that interplay between each other. <h3>Results:</h3> We confirmed the above-mentioned hypotheses. Our model explained 83% of fibromyalgia severity, which is a considerably large proportion. <h3>Conclusion:</h3> Our findings not only corroborate the importance of the two core (i.e., physical and psychological) pathways but also their interaction in their association with fibromyalgia severity. The understanding of these interconnections between alleged predisposing and perpetuating factors may optimise current approaches for treating fibromyalgia. Although the present research is the most comprehensive model of fibromyalgia severity to date, its cross-sectional design impedes to determine causal relationships. Longitudinal research is warranted. <h3>References</h3> [1] Macfarlane GJ, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017;76:318–28. doi:10.1136/annrheumdis-2016-209724. [2] Estévez-López F, et al. Adaptation profiles comprising objective and subjective measures in fibromyalgia: the al-Ándalus project. Rheumatology (Oxford)2017;56:2015–24. doi:10.1093/rheumatology/kex302 [3] Estévez-López, F., Rodriguez-Ayllon, M., Soriano-Maldonado, A., Acosta-Manzano, P., Segura-Jiménez, V., Álvarez-Gallardo, IC., et al. Lower Fatigue in Fit and Positive Women with Fibromyalgia: The al-Andalus Project. Pain Med (In press). DOI: 10.1093/pm/pny304 [4] Estévez-López, F., et al. The discordance between subjectively and objectively measured physical function in women with fibromyalgia: association with catastrophizing and self-efficacy cognitions. The al-Ándalus project. Disabil Rehabil 2018;40: 329-337. All the coefficients were significant. <h3>Acknowledgement:</h3> This work was supported by the Spanish Ministry of Economy and Competitiveness [I+D+i DEP2010-15639, I+D+I DEP2013-40908, I+D+I PSI2015-65241-R, and BES-2014-067612]; the Spanish Ministry of Education [FPU15/00002], and the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). University of Jaén, Plan de Apoyo a la Investigación 2017-2019 [EI_SEJ07_2017]. <h3>Disclosure of Interests:</h3> None declared