THU0507 Heterogenity of fibromyalgia: psychopathological characteristics of different subtypes and efficacy of therapy
Authors: A. Sarapulova, O. Teplyakova
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> fibromyalgia (FM) is one of the most complicated diseases in the rheumatology and therapeutic practice. Despite the relative success in diagnosing pathology and developing new diagnostic criteria, the treatment of FM remains uncertain. This, in particular, may be due to the presence of various subtypes of disease, which differ in their pathogenesis and, therefore, require differentiated therapy. <h3>Objectives</h3> to identify the subtypes of FM, to determine their basic psychopathological characteristics and adherence to therapy. <h3>Methods</h3> the study included 104 patients with FM according to 2010/2011 diagnostic criteria. All patients were questioned about their attitudes towards employment and sports, and determined the level of anxiety and depression by the HADS scale, as well as therapy compliance 2 months later. <h3>Results</h3> the results obtained support the presence of five subtypes of FM. Patients with a high level of anxiety (10.57±2.87) and minimal widespread pain index (WPI) (6.30±6.04) were included in Group 1. This group consisted of 40.35% of the total number of patients with the minimum average age (45 years) and the highest ratio of men/women (8/38). Group 1 was also characterised by the greatest employment (34 of 46 patients) and a relatively rare abandonment of physical exercises (14 of 46 patients). The second group of patients was conditionally called anxious-depressive because of the frequent detection of both anxiety and depression (11.33±4.64 and 11.67±3.64, respectively) with a moderate number of WPI (10.78±4.09). They differed from the Group 1 by mainly female sex and more frequent avoidance of physical exercises (8 of 18 patients). Group 3 (the proposed name is hysteroid) consisted of women with the maximum number of WPI (14.33±4.22) and low levels of anxiety and depression. Despite the average working age, they were mostly unemployed with the lowest level of adherence to physical activity (4 of 24 patients). The fourth subtype of FM consisted of patients with concomitant chronic diseases. They were expected to be the oldest (68 years on average) with a high number of painful areas (13.44±5.0), low levels of anxiety and depression. All of them refused to perform physical exercises and were unemployed. Finally, Group 5 included patients without concomitant affective and somatic disorders. This group has taken the middle position for all indicators, except the lowest level of anxiety and depression among all groups. The lowest rates of therapy compliance were demonstrated in Group 3. At the same time, the time of communication with these patients was the maximum. <h3>Conclusions</h3> patients with FM are a heterogeneous group, differing in their psychopathological characteristics. Younger patients are more likely to exhibit an elevated level of anxiety and depression and are prone to catastrophize their sensations, while older patients usually have a severe somatic pathology. They are often found in therapeutic practice, which makes it necessary to conduct educational programs on FM diagnostic and management for general practioners. We consider it very important to identify the hysteroid subtype of FM, since these patients are not inclined to seek recovery and represent a huge difficulty for the treating doctors. We proposed that they use their disease to attract the attention of others. <h3>Disclosure of Interest</h3> None declared