Anxiety and Depression in Fibromyalgia: Prevalence and Treatment Outcomes in a Rheumatology Outpatient Setting in Kerala (Code-T0359)

Introduction: Fibromyalgia is a chronic pain disorder characterized by widespread 
musculoskeletal pain, fatigue, sleep disturbances, and psychological symptoms, including 
anxiety and depression. The prevalence and impact of these psychiatric comorbidities on 
treatment outcomes in fibromyalgia patients remain understudied, especially in the Indian 
context. 
Aims and Objectives: 
To find out the prevalence of Depression and Anxiety in the Fibromyalgia patients attending 
the Rheumatology OPD in a tertiary care canter in Keralaand to observe the effect of 
treatment in patients’ quality of life. 
Primary objective 
To find out the prevalence of anxiety and depression in patients diagnosed with Fibromyalgia 
attending the Rheumatology OPD. 
Secondary objective 
1. To observe the effect of treatment of anxiety and depression on overall symptomatic 
improvement of the patients 
2. To study the quality of life of fibromyalgia patients with comorbid anxiety and 
depression. 
Methods: A longitudinal observational study was conducted at the Rheumatology OPD of 
Travancore Medical College Hospital, Kerala. A total of 53 fibromyalgia patients aged 18 
years and above were recruited based on 2010 ACR diagnostic criteria. Psychiatric 
assessments were conducted using the Hamilton Anxiety Rating Scale (HAM-A) and 
Hamilton Depression Rating Scale (HAM-D). Patients diagnosed with anxiety or depression 
were referred for psychiatric treatment and reassessed at 4-6 weeks and 12-15 weeks post
treatment initiation. Data were analyzed using SPSS. 
Results: A high prevalence of anxiety (72.5%) and depression (83.3%) was observed in 
fibromyalgia patients. Treatment with antidepressants and anxiolytics led to significant 
symptomatic relief, improved quality of life, and enhanced compliance with fibromyalgia 
management. 
Conclusion: Early identification and management of psychiatric comorbidities in 
fibromyalgia patients can lead to improved overall health outcomes. This study highlights the 
necessity of integrating psychiatric care into routine fibromyalgia treatment. 
Keywords: Fibromyalgia, Anxiety, Depression, Chronic Pain, Treatment Outcome, Mental 
Health