Effects of Depressive Symptoms on Cognition in Patients with Fibromyalgia

Qura-tul-ain Chauhadry; Muhammad Asif Naseer; Muhammad Adnan Manzar; Farhan Tariq; Zara Zafar; Sidra

doi:10.51253/pafmj.v76i5.11703

Authors

Qura-tul-ain Chauhadry Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Muhammad Asif Naseer Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Muhammad Adnan Manzar Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Farhan Tariq Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Zara Zafar Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Sidra Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i5.11703

Keywords:

Cognitive Decline, Depression, Fibromyalgia, Memory Impairment, Mood

Abstract

Objective: To study the effects of depressive symptoms on cognition in patients with fibromyalgia in our tertiary care hospital.

Study Design: Comparative cross-sectional.

Place and Duration of Study: Department of Medicine and Rheumatology, Combined Military Hospital, Malir Karachi Pakistan, from Jan to Jun 2023.

Methodology Two hundred and fifty diagnosed fibromyalgia patients were stratified into 02 groups: Group-A included patients having clinical depression, while Group-B included patients without depression. Cognitive functions were checked in both groups using the Montreal Cognitive Assessment Test (MoCA), and scores among two groups were compared.

Results. Out of 250 patients, 150(60%) were categorized into Group -A (with depression) and 100(40%) were categorized into Group-B (without depression). One hundred and thirty-eight (55.2%) were males, while 112(44.8%) were females. Median age with IQR of patients in our study was 50.5 (15.0) years. The Montreal Cognitive Assessment Test (MoCA) scores were calculated for both groups and their medians were compared. The overall median MoCA scores were 16(7.0). The median MoCA score in Group-A was 13.5(6.0), whilst Group-B had a score of 19.5(4).

Conclusion: Patients of fibromyalgia with depression had impaired cognitive functions as compared to fibromyalgia patients without depression.

Downloads

Download data is not yet available.

References

1. Khan Z, Naqvi R. Prevalence of Fibromyalgia in chronic kidney disease pre-dialysis patients: Experience from a Tertiary Care Renal unit in Pakistan. Pak J Med Sci 2021; 37(7): 1939-1942.

https://doi.org/10.12669/pjms.37.7.4474

2. Ruschak I, Toussaint L, Rosselló L, Aguilar MC, Fernández-Sáez J, Montesó-Curto P. Symptomatology of Fibromyalgia Syndrome in Men: A Mixed-Method Pilot Study. Int J Environ Res Public Health 2022; 19(3): 1724.

https://doi.org/10.3390/ijerph19031724

3. Iqbal F, Nisa Q, Majeed S. Prevalence of Fibromyalgia Among Critical Care Nurses and Coping Strategies. Pak J Inten Care Med 2025; 5(2).

https://doi.org/10.54112/pjicm.v5i02.209

4. Gau SY, Lee YH, Tsou HK, Huang JY, Chen X, Ye Z. Patients with Ankylosing Spondylitis Are Associated with High Risk of Fibromyalgia: A Nationwide Population-Based Cohort Study. Front Med 2021; 8: 618594.

https://doi.org/10.3389/fmed.2021.618594

5. Loge-Hagen JS, Saele A, Juhl C, Bech P, Stenager E, Mellentin AI. Prevalence of depressive disorder among patients with fibromyalgia: Systematic review and meta-analysis. J Affect Disord 2019; 245: 1098–1105.

https://doi.org/10.1016/j.jad.2018.12.001

6. Arnold LM, Fan J, Russell IJ, Yunus MB, Khan MA, Kushner I, et al. The fibromyalgia family study: A genome-wide linkage scan study. Arthritis Rheum 2013;65(1):1122–1128.

https://doi.org/10.1002/art.37842

7. Andres RL, Borras X, Feliu SA, Perez AA, Angarita ON, Moreno PP, et al. Peripheral immune aberrations in fibromyalgia: A systematic review, meta-analysis and meta-regression. Brain Behav Immun 2020; 87(1): 881–889.

https://doi.org/10.1016/j.bbi.2019.12.020

8. Adams LM, Turk DC. Psychosocial factors and central sensitivity syndromes. Curr Rheumatol Rev 2015; 11: 96–108.

https://doi.org/10.2174/1573397111666150619095330

9. Tahir A, Fatima DA, Khan MT. Association of Depression in Patients with Fibromyalgia Syndrome. Pak J Rehabilitat 2022; 11(1)1: 74–183. https:// doi.org/10.36283/pjr.zu.11.1

10. Kratz AL, Whibley D, Kim S, Sliwinski M, Clauw D, Williams DA. Fibrofog in Daily Life: An Examination of Ambulatory Subjective and Objective Cognitive Function in Fibromyalgia. Arthritis Care Res 2020; 72(12): 1669-1677.

https://doi.org/10.1002/acr.24089

11. Leavitt F, Katz RS, Mills M, Heard AR. Cognitive and Dissociative Manifestations in Fibromyalgia. J Clin Rheumatol 2002; 8(2): 77-84.

https://doi.org/10.1097/00124743-200204000-00003

12. Ambrose KR, Gracely RH, Glass JM. Fibromyalgia dys-cognition: concepts and issues. Reumatismo 2012; 64(4): 206-215.

https://doi.org/10.4081/reumatismo.2012.206

13. Teodoro T, Edwards MJ, Isaacs JD. A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review. J Neurol Neurosurg Psychiatry 2018; 89(12): 1308-1319.

https://doi.org/10.1136/jnnp-2017-317823

14. Kravitz HM, Katz RS. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatol Int 2015; 35(7): 1115-1125.

https://doi.org/10.1007/s00296-014-3208-7

15. Elkana O, Nimni JN, Ablin R, Shorer V. The Montreal Cognitive Assessment Test (MoCA) as a screening tool for cognitive dysfunction in fibromyalgia. Plos One 2018; 13(7).

https://doi.org/10.55563/clinexprheumatol/3yxu6p

16. Gelonch O, Garolera M, Valls J, Rosselló L, Pifarré J. Executive Function in Fibromyalgia: Comparing Subjective and Objective Measures. Compr Psychiatry 2016; 66: 113–122.

https://doi: 10.1016/j.comppsych.2016.01.002

17. Landrø NI, Stiles TC, Sletvold H. Memory functioning in patients with primary fibromyalgia and major depression and healthy controls. J Psychosom Res 1997; 42(3): 297–306.

https://doi.org/10.1016/s0022-3999(96)00301-7

18. Sletvold H, Stiles TC, Landrø NI. Information processing in primary fibromyalgia, major depression and healthy controls. J Rheumatol 1995; 22(1): 137–142.

19. Grace GM, Nielson WR, Hopkins M, Berg MA. Concentration and Memory Deficits in Patients with Fibromyalgia Syndrome. J Clin Exp Neuropsychol 2010; 21: 37–41.

https://doi.org/10.1076/jcen.21.4.477.876

20. Martinsen S, Flodin P, Berrebi J, Lofgren M, Bileviciute-Ljungar I, Ingvar M, et al. Fibromyalgia patients had normal distraction related pain inhibition but cognitive impairment reflected in caudate nucleus and hippocampus during the Stroop color word test. PLoS One 2014; 9(10).

https://doi.org/10.1371/journal.pone.0108637