Psychology Research and Behavior Management (Mar 2024)
A Comparative Analysis of Cognitive Deficits in Rheumatoid Arthritis and Fibromyalgia: Impact of Symptoms Severity and Its Clinical Implications
Abstract
Carmen M Galvez-Sánchez,1,* Stefan Duschek,2,* Gustavo A Reyes del Paso3,* 1Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain; 2Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria; 3Department of Psychology, University of Jaén, Jaén, Spain*These authors contributed equally to this workCorrespondence: Carmen M Galvez-Sánchez, Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Building 31, Murcia, 30100, Spain, Tel +34 868 88 868 88 7328, Email [email protected]: Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated.Patients and Methods: A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons.Results: Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients.Conclusion: The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.Plain Language Summary: The investigation substantiated noteworthy impairments in attention, memory, and executive functions among individuals diagnosed with Fibromyalgia Syndrome (FMS) and Rheumatoid Arthritis (RA).The heightened cognitive deficits observed in FMS patients compared to those with RA could be attributed in part to the heightened severity of pain and secondary symptoms characteristic of FMS.Semantic clustering, by leveraging cognitive resources optimally, may serve as a compensatory mechanism for memory deficits and thus warrants inclusion in interventions aimed at assisting patients in coping with cognitive impairments.Incorporating cognitive deficit screenings into routine diagnostic protocols for FMS and RA is recommended, as it may facilitate the development of personalized treatment strategies aimed at enhancing the overall quality of life for affected individuals.Keywords: fibromyalgia syndrome, rheumatoid arthritis, cognitive impairments, depression, anxiety, fatigue, insomnia
