The impact of obsessive beliefs on fibromyalgia: The mediating role of emotional dysfunction and obsessive-compulsive symptoms

Abstract

Background: The role of obsessive beliefs in the development and maintenance of Fibromyalgia syndrome (FMS) remains unclear. This study aims to compare patients with FMS and controls in terms of obsessive beliefs, quality of life, and comorbid psychiatric symptoms. In addition, this study uses structural equation modelling (SEM) to examine whether obsessive beliefs influence FMS symptom severity directly or through mediating factors. Method: This study was conducted at Uşak Training and Research Hospital, Turkey, involving 116 adults, including 76 FMS patients (mean age = 43.2) and 40 controls (mean age = 45.8). Both groups completed the Short Form 12 Health Survey (SF-12), Obsessive Beliefs Questionnaire (OBQ) and Symptom Checklist-90 Revised (SCL-90-R), with the FMS group additionally completing the Fibromyalgia Impact Questionnaire (FIQ). SEM was applied to examine the direct and indirect effects of obsessive beliefs on FMS symptom severity. Results: In the FMS group, SF-12 subscale scores were lower, while OBQ-44 and SCL-90-R subscale scores (except for anger-hostility, phobic anxiety, and paranoid ideation) were higher compared to controls (all p < .05). The final model showed that the OBQ-Total Score negatively predicted SF-12 Role Emotional (β = -0.22, p = .042) and positively predicted SCL-90 Obsessive-Compulsive (β = 0.25, p = .013). SF-12 Role Emotional negatively predicted both the FIQ (β = -0.50, p < .001) and SCL-90 Obsessive-Compulsive (β = -0.40, p = .001), while SCL-90 Obsessive-Compulsive positively predicted the FIQ (β = 0.39, p = .002). Conclusions: Our findings highlight the role of obsessive beliefs and emotional dysfunction in FMS severity, suggesting that targeting these factors may help alleviate symptoms. Future research should examine targeted therapies to enhance emotional regulation and cognitive flexibility in FMS.