Personality and fibromyalgia

Abstract

Personality is composed of stable predispositions that define an idiosyncratic pattern of cognition, emotion, and behavior that can facilitate or deteriorate general health, including longevity and mortality, management and outcomes of the diseases, and health care costs. In the case of chronic pain, patients' personality may influence both the intensity of the symptoms and the affective response, their subjective relevance and sense of control, patients' coping style, and their interactions with clinicians, therapeutic response and the perception of improvement. Some of the numerous investigations on the definition of a specific personality profile in fibromyalgia present with significant methodological limitations and observe contradictory results that make it remaining a controversial issue. Also, several of the conclusions of some of the studies that observe a personality profile distinctive of people with fibromyalgia can contribute to the nosological discredit of this syndrome and hinder the relationship of patients with the health system. More interesting, perhaps, is the study of what dimensions of personality may positively or negatively influence the clinical status and therapeutic response of patients, including their interaction with health professionals who treat them. Several studies suggest that personality profile assessments might allow the definition of subgroups of patients more based on pathological processes susceptible to moderation, especially the tendency to negative emotionality and behavioral inhibition, rather than based on mere symptoms severity. This differentiation could facilitate the identification of those people most vulnerable to the development of fibromyalgia, the individualized selection of the most appropriate strategies to facilitate the fulfillment of prescriptions and promotion of the therapeutic alliance, as well as the discrimination of the most appropriate therapeutic options for each profile and its sequencing.