Relationship between the body image and level of pain, functional status, severity of depression, and quality of life in patients with fibromyalgia syndrome

The aims were to investigate how the body image is affected in fibromyalgia syndrome (FMS) in comparison to healthy people, as well as to explore the relationship of the body image with the level of pain, functional status, severity of depression, and quality of life (QoL). Demographic variables, symptoms of fibromyalgia, and number of fibromyalgia tender points for 51 patients with FMS and 41 control subjects were recorded. All patients were asked to mark the level of pain on visual analogue scale (VAS). Six-minute walking test was recorded for functional assessment. The impact of the disease was evaluated by fibromyalgia impact questionnaire (FIQ). All patients were asked to complete body image scale (BIS), Beck depression inventory (BDI), and short form-36 (SF-36). There were no differences between groups with regard to demographic variables (p>0.05). Mean VAS was 7.5 +/- 1.4 for the patients with FMS and 0.3 +/- 0.4 for control subjects (p<0.05). Mean FIQ was 70.8 +/- 13.2 and 8.2 +/- 9.6 for the FMS and control groups, respectively (p<0.05). Mean BIS and BDI were 106.5 +/- 24.0 and 20.2 +/- 11.2 for FMS group and 66.3 +/- 23.4 and 3.4 +/- 4.0 for control group, respectively (p<0.05). SF-36 subscores were found to be significantly lower in patients with FMS than control subjects (p<0.05), except for the social function subscore. BIS score had significant relationships both with VAS (r=0.843) and FIQ (r=0.290) in patients with FMS (p<0.05). There were significant relationships between BIS scores and SF-36 pain (r=-0.288), energy/vitality (r=-0.519), mental health (r=-0.442), and general health (r=-0,492) subscores (p<0.05). Body image was associated with VAS in the multivariate linear regression analysis. The results of the present study indicate that body image is disturbed in patients with FMS compared to control subjects. For the evaluation of the level of pain, impact of the disease, and QoL in patients with FMS, it would be useful to consider the relationship of the body image disturbance with these parameters.