Patients With Fibromyalgia More Susceptible to Psychological Stress During COVID-19 Pandemic


The COVID-19 pandemic continues to negatively impact symptom severity, sleep quality, and mood in patients with fibromyalgia.

Patients with fibromyalgia (FM) were more affected by psychological stressors, thus negatively affecting sleep quality, symptom severity, and mood, during the COVID-19 pandemic, according to a study published in Advances in Rheumatology.1

“During the pandemic, individuals faced psychological stress caused by fear and anxiety due to the high transmission and mortality rate of the disease, the social isolation, economic problems, and difficulties in reaching health services,” investigators explained. “In controlled studies in the literature, psychological, physical and/or autoimmune stressors were found to increase FM symptoms. Anxiety and psychological stress cause an increase in symptom severity in FM patients and adversely affect their quality of life.”

This cross-sectional pilot study included a total of 62 patients, 31 participants with FM and 31 participants in the control group. Eligible patients were between the ages of 18 and 65 years who applied to the physical medicine and rehabilitation outpatient clinic between December 15, 2020, and February 1, 2021. Patients in the FM cohort were diagnosed with primary FM for over 1 year, had not changed treatments or dosage for 3 months, and have been clinically stable for a minimum of 3 months.

Age, gender, height, weight, body mass index, marital and educational status, and profession were recorded.

Investigators evaluated symptom severity, sleep quality, and mood utilizing the Revised Fibromyalgia Impact Questionnaire (FIQR), Pitsburg Sleep Quality Index (PSQI), and Hospital Anxiety Depression Scale (HADS). They determined anxiety and fear regarding COVID-19 with the Fear of COVID-19 Scale (FCV-19S) and Coronavirus Anxiety Scale (CAS) and compared the results between both cohorts.

Investigators did not discover significant differences between the 2 groups regarding demographics, education level, marital status, comorbidities, and occupation.

The FIQR, PSQI, FCV-19S, CAS, HAD-A, and HAD-D scores were all significantly higher in the FM cohort when compared with patients in the control group. Further, there was a correlation between the FCV-19S and CAS scores and higher FIQR, PSQI, and HAD-anx results in this patient population. However, no correlation was found between FCV-19S and CAS and the HAD-dep results.

The study was limited by its cross-sectional design and small sample size.

“Particular attention should be paid to patients with previous psychological disorders such as FM patients during pandemic periods. Because these individuals are more affected by psychological stress than other individuals, and this situation negatively affects the symptom severity, sleep quality, and mood in FM patients,” investigators concluded. “We still continue to see the effects of the COVID-19 pandemic. Therefore, more studies with more participants are necessary to describe the challenges lived by fibromyalgia population.”


Cankurtaran D, Tezel N, Ercan B, Yildiz SY, Akyuz EU. The effects of COVID-19 fear and anxiety on symptom severity, sleep quality, and mood in patients with fibromyalgia: a pilot study. Adv Rheumatol. 2021;61(1):41. Published 2021 Jun 30. doi:10.1186/s42358-021-00200-9

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