Background. Fibromyalgia (FM) is a nociplastic pain condition accompanied by substantial psychological burden. Chronic migraine (CM) frequently co-occurs with FM, but its contribution to psychological functioning remains unclear. Understanding whether FM patients with and without CM display distinct psychological profiles may support more personalised interventions. Objective. To compare psychological functioning across women with FM, CM, and comorbid FM+CM, and to identify transdiagnostic psychological profiles through cluster analysis. Methods. A total of 318 women participated: 130 with FM, 97 with CM, and 91 with FM+CM. Participants completed self-report measures assessing mental functioning, depressive and anxiety symptoms, global distress, and defensive functioning. Diagnostic group differences were tested using Kruskal–Wallis analyses. A k-means cluster analysis identified psychological profiles independent of diagnostic category. Results. FM and FM+CM showed comparable levels of depressive symptoms, anxiety, distress, and defensive functioning, whereas CM displayed significantly lower symptom severity across all measures (p=0.001). Cluster analysis yielded three transdiagnostic profiles: a vulnerable cluster (n=73), with high distress and low mental functioning; an intermediate cluster (n=122); and a resilient cluster (n=76), characterised by adaptive functioning. FM and FM+CM were predominantly epresented in the vulnerable and intermediate clusters, while CM participants were overrepresented in the resilient cluster (χ²(4) = 21.41, p=0.001). Conclusion. FM patients, particularly those with comorbid CM, exhibit heightened psychological vulnerability compared to individuals with CM alone. These findings underscore the heterogeneity of psychological functioning within FM and support a dimensional, transdiagnostic framework to guide individualised clinical care.
A transdiagnostic approach to psychological risk in fibromyalgia and comorbid chronic migraine / Cangelosi, Martina; Cavicchioli, Marco; Mesce, Martina; Benfante, Agata; Torelli, Alessandro; Castelli, Lorys; Sarzi-Puttini, Piercarlo; Galli, Federica; Bottiroli, Sara. - (2026). ( The 8th International Congress on Controversies in Fibromyalgia Cracovia (Polonia) ).
A transdiagnostic approach to psychological risk in fibromyalgia and comorbid chronic migraine
Marco Cavicchioli;Martina Mesce;Alessandro Torelli;Federica Galli;
2026
Abstract
Background. Fibromyalgia (FM) is a nociplastic pain condition accompanied by substantial psychological burden. Chronic migraine (CM) frequently co-occurs with FM, but its contribution to psychological functioning remains unclear. Understanding whether FM patients with and without CM display distinct psychological profiles may support more personalised interventions. Objective. To compare psychological functioning across women with FM, CM, and comorbid FM+CM, and to identify transdiagnostic psychological profiles through cluster analysis. Methods. A total of 318 women participated: 130 with FM, 97 with CM, and 91 with FM+CM. Participants completed self-report measures assessing mental functioning, depressive and anxiety symptoms, global distress, and defensive functioning. Diagnostic group differences were tested using Kruskal–Wallis analyses. A k-means cluster analysis identified psychological profiles independent of diagnostic category. Results. FM and FM+CM showed comparable levels of depressive symptoms, anxiety, distress, and defensive functioning, whereas CM displayed significantly lower symptom severity across all measures (p=0.001). Cluster analysis yielded three transdiagnostic profiles: a vulnerable cluster (n=73), with high distress and low mental functioning; an intermediate cluster (n=122); and a resilient cluster (n=76), characterised by adaptive functioning. FM and FM+CM were predominantly epresented in the vulnerable and intermediate clusters, while CM participants were overrepresented in the resilient cluster (χ²(4) = 21.41, p=0.001). Conclusion. FM patients, particularly those with comorbid CM, exhibit heightened psychological vulnerability compared to individuals with CM alone. These findings underscore the heterogeneity of psychological functioning within FM and support a dimensional, transdiagnostic framework to guide individualised clinical care.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
