POS1176 THE IMPACT OF COVID-19 QUARANTINE ON MENTAL HEALTH OF PATIENTS WITH FIBROMYALGIA
Authors: F. Ingegnoli, M. Buoli, C. Posio, R. DI Taranto, R. Caporali
Journal: Annals of the Rheumatic Diseases (2021)

Background: Detrimental psychological effects, including symptoms of post-traumatic stress disorder (PTSD), stress, anxiety, and depression have been related to COVID-19 quarantine measures (1). These aspects may be particularly relevant in stress-related disorders such as fibromyalgia (FM) in which previous evidence demonstrated a causal effect of psychological stressors on chronic non-inflammatory pain of FM (2). Recent studies highlighted a significant worsening of FM symptoms after COVID-19 related lockdown period (3-4), but the levels of perceived stress and distress have not been evaluated yet. Objectives: The aim of this study is to establish the COVID-19 related perceived stress and distress among patients with FM who experienced the COVID-19 quarantine in Italy. Data were retrieved from a larger nationwide online survey involving patients affected by different rheumatic diseases (RD). Methods: We collected data from May to September 2020 from RD patients living in Italy during the COVID-19 quarantine by an ad-hoc online survey. Eleven associations of RD patients sent a call by using their mailing list, webpages and social network. They asked to complete an anonymous online survey which included the Perceived Stress Scale (PSS), and the Impact Event Scale-Revised (IES-R). Descriptive statistics were used to summarize results. Results: 79 of 507 (15.6%) of RD patients who completed the survey declared to have been diagnosed FM. 77 (97.5%) were females, with a mean (± SD) age of 51.0 ± 12.4 yrs. In FM patients, the mean (SD) PSS score was 23.8 ± 8.1. In particular, 8 (10.1%) reported low, 38 (48.1%) moderate and 33 (41.8%) high PSS scores. Moreover, IES-R mean (SD) score was 38.5 ± 17.2. Among FM patients, 51 (64.6%) reported scores greater than 33, indicating the probable presence of a PTSD. With regard to the IES-R subscale scores, the total sample did not show a prominence of one of the three main domains: intrusion (13.9 ± 7.3), avoidance (11.9 ± 6.1) and hyperarousal (12.6 ± 5.9). In these FM patients, self-reported major sources of anxiety were related to personal and relatives’ health (59.5%), followed by social withdrawal (21.5%) and employment loss/financial difficulties (11.4%). There was a slight increase of self-reported use of antidepressants (15 [18.9%] vs 16 [20.2%]) and anxiolytics drugs (4 [5.1%] vs 5 [6.3%]) after lockdown period. Conclusion: These results confirm that psychosocial stress and distress were highly pervasive in FM after COVID-19 national lockdown. It is known that stressed status may exacerbate and/or precipitate later development of FM symptoms. These data support the substantial worsening of somatic burden of FM after lockdown period reported in previous studies (3-4). Coping strategies should be implemented to ameliorate psychological well-being of these patients in this stressful era. References: [1]Brooks SK, et al. Lancet. 2020;395:912-20. [2]Hung CH, et al. Ann Rheum Dis 2020;79:1644-1656. [3]Batres-Marroquín AB, et al. J Clin Rheumatol. 2020 Epub ahead of print. [4]Cavalli G, et al. Rheumatology 2021;60:465-467. Acknowledgements: We wish to thank the Lombard Association of Rheumatic Diseases (ALOMAR) for its invaluable contribution to the planning and dissemination the survey, all the Italian associations among which the National Association of People with Rheumatic and Rare Diseases (APMARR) and National Association of People with Rheumatic Diseases (ANMAR) that disseminated the survey through social media. The authors are grateful to all patients for contributing to this project. Disclosure of Interests: Francesca Ingegnoli: None declared, Massimiliano Buoli: None declared, Cristina Posio: None declared, Raffaele Di Taranto: None declared, Roberto Caporali Speakers bureau: Abbvie, Amgen, BMS, Celltrion, Galapagos, Gilead, Lilly, Pfizer, Roche, UCB, Sanofi, Fresenius Kabi, Samsung bioepis, MSD, Consultant of: Galapagos, Gilead, Lilly,Janssen, MSD.