Search Results (35)

Background/Objectives: Chronic low back pain (CLBP) is the leading global cause of years lived with disability, but long-term real-world evidence for non-surgical management remains scarce, particularly in low- and middle-income countries. This study aimed to describe 5-year trajectories of pain, disability, healthcare utilization, patient satisfaction, and surgical conversion among patients with non-specific CLBP initially managed non-surgically at a tertiary spine center in Northwest China. We also compared long-term outcomes between unimodal therapy and multidisciplinary biopsychosocial care and examined baseline demographic, clinical, and psychosocial predictors of treatment success and conversion to surgery. Methods: We conducted a 5-year retrospective cohort study of consecutive patients with non-specific CLBP at a tertiary spine center in Northwest China. Of 485 consecutive patients screened for eligibility, 420 were enrolled and were compared on the basis of unimodal therapy with multidisciplinary biopsychosocial care. Primary outcomes were pain (Numerical Pain Rating Scale, NPRS) and disability (Oswestry Disability Index, ODI), analyzed using linear mixed-effects models; predictors of surgical conversion were identified via multivariable Cox regression. Results: Of the 420 patients, 352 (83.8% retention) completed the 5-year follow-up. Both pain and disability improved substantially during the first 12 months. Thereafter, pain intensity increased slightly (NPRS from 4.8 to 5.4), whereas functional disability continued to improve (ODI from 31.7 to 26.5). Early multidisciplinary care was associated with sustained superior outcomes (adjusted functional disability (ODI) difference: −8.2 points at 5 years) and a 42% lower observed risk of surgery (HR = 0.58). The cumulative 5-year surgical rate was 14.2%, with high pain catastrophizing as the strongest independent predictor (HR = 3.10). Conclusions: In patients with non-specific CLBP, non-surgical management yields substantial 12-month gains; function continues to improve through 5 years, while pain shows partial recurrence. Early multidisciplinary biopsychosocial care was associated with more durable outcomes and lower surgical conversion; because treatment was not randomized, these associations warrant confirmation in pragmatic trials and support routine psychosocial screening and stratified care. Full article

Background: Over the past decades, the global onset of menarche has progressively advanced, driven by complex interactions between metabolic, psychosocial, and environmental factors. Beyond its reproductive significance, menarche represents a critical developmental milestone that coincides with increased vulnerability to mental health difficulties. Contemporary determinants such as childhood obesity, early-life adversity, and exposure to endocrine-disrupting chemicals (EDCs) may accelerate pubertal timing while simultaneously shaping adverse psychological trajectories during adolescence. Objectives: This review aims to provide a translational and clinically oriented synthesis of modern determinants of earlier menarche and their associations with mental health outcomes in girls and adolescents, highlighting implications for early identification, prevention, and integrated clinical care. Methods: We conducted a narrative review mapping a scoping literature search conducted using PubMed/Medline, Scopus, and PsycINFO, focusing on literature from the last decade (2016–2026), with emphasis on systematic reviews, meta-analyses, and longitudinal cohort studies. Evidence was synthesized across biological, psychosocial, and environmental domains. Results: Accumulating evidence indicates that higher childhood adiposity, psychosocial stress, and EDC exposure are consistently associated with advanced pubertal timing. Earlier menarche correlates with an elevated risk of depressive symptoms, anxiety, self-harm, and body image-related distress, although effect sizes vary across populations. Emerging longitudinal data suggest that the peri-menarcheal period represents a critical window for symptom exacerbation. These associations appear to be mediated by biological mechanisms (e.g., hormonal shifts, hypothalamic–pituitary–adrenal (HPA) axis reactivity) and social processes including peer-comparison dynamics and premature sexualization. Conclusions: Earlier menarche acts as a biopsychosocial sentinel event rather than an isolated gynecological milestone. Integrating mental health screening and anticipatory guidance into pediatric and gynecological care is essential for early risk detection. A multidisciplinary, equity-oriented approach is required to address both individual vulnerability and broader environmental determinants. Full article

Background/Objectives: Endometriosis is a chronic gynecological condition affecting approximately 10% of women of reproductive age and is associated with chronic pain, fatigue, infertility, and reduced quality of life. Beyond its physical burden, delayed diagnosis, healthcare dismissal, and inadequate support may contribute substantially to psychological distress. In line with growing efforts to promote mental health and wellbeing within healthcare settings, this study explored women’s experiences of healthcare services and the psychological impact of living with endometriosis. Methods: A qualitative study was conducted using thematic analysis of 2500 publicly available Twitter/X posts shared by accounts self-presenting as women discussing experiences of endometriosis. Results: Three overarching themes were identified: (1) Institutional Invalidation of Women’s Endometriosis Experiences, (2) Living with the Multidimensional Burden of Endometriosis, and (3) Reimagining Endometriosis Care. Participants described chronic pain, reproductive uncertainty, and significant emotional distress that were frequently intensified by delayed diagnosis and experiences of not being believed or taken seriously within healthcare settings. Accounts suggested that suffering was shaped not only by disease symptoms but also by interactions with healthcare systems that undermined the legitimacy of women’s experiences. Conversely, validation, empathy, and collaborative communication were associated with improved wellbeing and engagement with care. Participants advocated for greater awareness of endometriosis, earlier diagnosis, and more integrated models of support. Conclusions: Endometriosis should be understood as a biopsychosocial condition whose impact extends beyond physical symptoms alone. The narratives analyzed highlight how psychological distress may be amplified by experiences of invalidation, delayed recognition, and fragmented care. Improving outcomes requires timely diagnosis, patient-centered healthcare interactions, and the integration of psychological support within multidisciplinary endometriosis services. Full article

Background: Functional Neurological Disorder (FND) and Postural Orthostatic Tachycardia Syndrome (POTS) are both complex, often debilitating conditions that frequently affect young women and involve high symptom burdens and psychiatric comorbidity. Although clinical overlap between these two disorders has long been observed, quantitative evidence assessing their co-occurrence has been lacking. Objective: The aim of this review was to determine the frequency of POTS in patients with FND and FND in patients with POTS through meta-analysis of the available literature, and to describe overlapping putative factors between the two conditions. Methods: A comprehensive literature search was conducted across PubMed and Google Scholar up to April 2025. The meta-analysis was conducted and reported in accordance with PRISMA guidelines. Studies reporting original data on the frequency of POTS in individuals with FND and FND in individuals with POTS were included. Meta-analyses were performed using random-effects models. Quality assessment was conducted using the JBI critical appraisal tools. Evidence relating to overlapping putative factors between POTS and FND was synthesised narratively. Results: From over 37,000 records, 11 studies comprising 1199 participants were included. The pooled proportion of POTS among individuals with FND was 14% (95% CI: 5–26%), with the highest rates seen in those with functional seizures (26%). Substantial heterogeneity (I² = 94.6%) reflected differences in methodology, age group, setting, and diagnostic criteria. Evidence regarding FND in POTS remains limited. Overlapping putative factors included biopsychosocial predisposing factors, female gender, altered interoception, psychological trauma and stress response, immune dysregulation, neurohumoral factors and comorbidities. Conclusions: The findings suggest that the proportion of POTS among individuals with FND is higher than expected by chance alone. An overview of their overlap highlights potential shared biopsychosocial mechanisms and provides a framework for integrated clinical care. Recognising their co-occurrence and the need for careful differential diagnosis between these conditions may inform screening, diagnosis, and multidisciplinary management strategies. This perspective supports a non-dualistic, neuroscience-based approach and identifies priorities for future research. Full article

Background: Fibromyalgia is a chronic pain syndrome in which treatment effectiveness may be influenced by biological, psychological, social, and nutritional factors. This study aimed to identify clinical, psychosocial, nutritional, and selected individual factors associated with patients’ perceived overall treatment effectiveness among women with fibromyalgia. Specifically, we examined whether fibromyalgia symptom severity, psychological and social quality of life, diet quality, vitamin D₃ supplementation, treatment duration, and selected individual characteristics were associated with patients’ perceptions of treatment effectiveness. Methods: A cross-sectional online study included 195 women with physician-diagnosed fibromyalgia who reported using medications and/or supplements. Fibromyalgia severity (FAS, FIQR), quality of life in psychological and social domains (WHOQOL-BREF), diet quality (pHDI, nHDI, DQI), vitamin D₃ supplementation, and treatment duration were assessed. Cluster analysis and hierarchical linear regression were performed to identify factors associated with self-perceived treatment effects. Results: Women reporting lower treatment effects presented greater symptom severity, higher FIQR scores, and lower quality of life in psychological and social domains. No significant differences were observed according to age, BMI, diet quality, or self-reported daily vitamin D₃ supplementation. In the final regression model, treatment duration (β = 0.246; p < 0.001), quality of life in the psychological domain (β = 0.173; p = 0.035) and social domain (β = 0.158; p = 0.039), and symptom severity (β = −0.196; p = 0.041) independently predicted self-perceived treatment effects. Conclusions: Better psychological and social well-being, lower symptom severity, and longer treatment duration were associated with higher perceived treatment effectiveness, whereas neither diet quality nor self-reported daily vitamin D₃ supplementation was associated with this outcome. These findings support a multidisciplinary biopsychosocial model of care integrating nutritional, medical, psychological, and social interventions. Full article

Perimenopause is a complex, multidimensional biopsychosocial transition characterized by endocrine fluctuations that interact with psychological vulnerabilities, sleep disturbances, and physical symptoms, significantly impacting women’s health-related quality of life (HRQoL). While hormonal therapies remain a viable option, there is an increasing demand for acceptable and accessible non-pharmacological interventions. This structured narrative review synthesizes recent randomized controlled trial (RCT) evidence evaluating integrative non-pharmacological interventions for mental health and HRQoL during the menopausal transition. A structured search was performed in MEDLINE via PubMed, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published between 1 January 2021 and 30 June 2026. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale: Nineteen RCTs met the eligibility criteria and were categorized into five domains: (i) lifestyle and structured exercise interventions, (ii) psychological, educational, and coaching-based interventions, (iii) mind–body and meditative movement interventions, (iv) acupuncture and traditional technique-based interventions, and (v) herbal and nutraceutical interventions. Overall, physical activity, Mediterranean- or DASH-oriented dietary counseling, cognitive behavioral therapy (CBT), health coaching, mindfulness-based stress reduction (MBSR), yoga, and Tai Chi were associated with favorable findings for depressive and anxiety symptoms, perceived stress, insomnia, sexual functioning, and menopause-specific quality of life. Acupuncture, moxibustion, and specific nutraceuticals yielded positive but highly heterogeneous or formulation-specific outcomes. The breadth of reported effects appeared to vary according to comparator selection, with broader findings generally observed against inactive controls than against active or sham comparators. Current evidence supports integrating tailored non-pharmacological strategies within patient-centered perimenopausal care. However, substantial heterogeneity in perimenopause definitions, small sample sizes, high attrition in select trials, and a lack of long-term follow-up limit generalizable conclusions. Future research requires standardized staging, active comparative-effectiveness designs, and implementation evaluation within multidisciplinary healthcare settings. Full article

Children undergoing cancer treatment face repeated, prolonged hospitalisations carrying substantial risks of psychological distress, social isolation, and impaired development. Volunteers offering structured non-medical activities are widely employed to complement professional psychosocial care in paediatric oncology settings, yet empirical evidence examining their role specifically—as distinct from professionally delivered psychosocial interventions—remains sparse. This narrative review, conducted in accordance with SANRA criteria and drawing on a structured search of PubMed, PsycINFO, and Google Scholar (2000–2025), supplemented by a targeted verification search in July 2026, synthesises the theoretical and preliminary empirical basis for volunteer involvement, critically evaluates associated clinical risks, and proposes evidence-informed recommendations for paediatric oncology clinical practice. Three theoretical frameworks provide the conceptual grounding for volunteer activities: developmental psychological models (Piaget; Erikson), stress and coping theory (Lazarus and Folkman), and the biopsychosocial model (Engel). Indirect empirical evidence—derived predominantly from professionally delivered interventions—supports short-term benefits of structured distraction, play, and social activities on procedural anxiety, pain experience, and sense of social inclusion; the sole study examining volunteer-facilitated activities specifically in paediatric oncology reported meaningful reductions in distress and high family satisfaction. Eight categories of clinical risk are identified, including physical and psychological overload, erosion of child autonomy, suppression of authentic emotional expression, and inadequate coordination with healthcare staff. Six practice recommendations are proposed, centred on a working definition of the volunteer role, mandatory pre-access training, genuine individualisation including cultural adaptation, multidisciplinary-team-led coordination, and structured programme evaluation. Volunteer involvement can meaningfully complement professional psychosocial care when delivered within a structured, supervised, and multidisciplinary-team-coordinated framework. The paediatric oncology team occupies a pivotal role in realising the potential benefits while safeguarding children from associated risks. Prospective research employing standardised volunteer programme definitions and validated child-reported outcome measures is urgently needed to build an evidence base commensurate with the clinical importance of this practice. Full article

This study aimed to assess the relative impact of the Osijek multidisciplinary biopsychosocial program for chronic low back pain (CLBP) compared with standard multimodal care with respect to pain intensity, disability, health-related quality of life, anxiety, depression, stress, and sleep quality using standardized self-assessment questionnaires and a smartwatch. A total of 128 patients treated at the Department of Pain Management, University Hospital Osijek, were randomly allocated to two groups. The multidisciplinary biopsychosocial group participated in a structured four-week program combining education, exercise, and individualized multidisciplinary care, while the multimodal group received conventional conservative treatment including pharmacotherapy and selected physical therapy modalities. The four-week intervention included standardized self-report questionnaires, a sociodemographic data form, and a Fitbit Charge 3 smartwatch for objective monitoring of sleep and physical activity. A significant reduction in pain intensity was observed across numerical scales and most questionnaire measures (Wilcoxon test, p < 0.01), except for the subscale assessing difficulties in performing daily activities due to sleep deprivation. Participants who underwent the multidisciplinary biopsychosocial treatment exhibited significant improvements (p < 0.03) in pain intensity, disability, health-related quality of life, stress, anxiety, and sleep quality compared with those receiving multimodal treatment. In both groups, a weak negative correlation was found between sleep quality and daily step count (Spearman’s rho = −0.234, p = 0.04). A multidisciplinary biopsychosocial program was associated with greater improvements in health-related quality of life, psychological well-being, and sleep quality in patients with chronic low back pain compared with a multimodal conservative approach. Increased daily physical activity was linked to improvements in anxiety and sleep. Although this study was designed as a randomized controlled trial, certain baseline differences between groups should be considered when interpreting the findings. Full article

Background: Occlusal dysesthesia (OD), also known as phantom bite syndrome, is characterized by the subjective sensation of an uncomfortable or “wrong” bite despite the absence of objective occlusal pathology. This scoping review aimed to synthesize the current evidence on the epidemiology, etiology, clinical presentation, diagnosis, and management of OD. Methods: The PubMed, Google Scholar, Scopus, Web of Science, ScienceDirect, and Cochrane Library databases were systematically searched using the terms “phantom bite,” “occlusal dysesthesia,” “occlusal hyperawareness,” “occlusal hypervigilance,” “uncomfortable occlusion,” and “oral cenestopathy.” Studies were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria (2020), and evidence quality was assessed using the Oxford Center for Evidence-Based Medicine levels of evidence. Results: A total of 20 studies were included. OD predominantly affected middle-aged women, with symptom durations often exceeding several years, and was believed to be caused by disorderly central sensory processing or maladaptive signal processing rather than by a primary occlusal abnormality, with high rates of psychiatric comorbidities reported. Current evidence supports conservative multidisciplinary management, including patient education, cognitive behavioral therapy, and supportive pharmacotherapy, and irreversible dental interventions are contraindicated. Conclusions: OD is a complex biopsychosocial condition requiring multidisciplinary care. The current low-quality evidence is primarily obtained from case reports and case series. Therefore, high-quality controlled trials are urgently required to establish evidence-based diagnostic criteria and treatment protocols. Full article

Endometriosis is a chronic, estrogen-dependent inflammatory condition associated with severe pelvic pain and infertility. Beyond its somatic manifestations, it is increasingly recognized as a disorder with significant psychological sequelae. This review examines the bidirectional relationship between endometriosis-related chronic pain and mental health disorders, with the aim of highlighting the importance of integrated, multidisciplinary management strategies. Relevant literature was synthesized to explore the pathophysiology of endometriosis, mechanisms of pain chronification, and the prevalence and impact of psychiatric comorbidities, including depression, anxiety, body image disturbance, and sexual dysfunction. Chronic pain and diagnostic delays contribute substantially to psychological distress in patients with endometriosis. High rates of affective disorders have been consistently reported, with significant repercussions on social functioning, intimate relationships, and overall quality of life. Although treatment traditionally focuses on symptom control, evidence supports the efficacy of approaches that concurrently address mental health needs. Endometriosis represents a paradigmatic example of the interplay between chronic somatic illness and mental health. Future research should prioritize the integration of psychological assessment and intervention within endometriosis care pathways, alongside the development of targeted, biopsychosocial treatment models. Full article

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed treatment for higher weight and diabetes. Because they also influence appetite and reward processes, these medications may shape eating behaviours, emotions, and body image, raising new challenges for eating disorder (ED) research and clinical care. This narrative review synthesises emerging evidence on the psychological and behavioural effects of GLP-1RA use within a biopsychosocial and equity framework. Method: Using a narrative, non-systematic approach, we conducted targeted searches across major databases (2015–September 2025) with combined GLP-1RA and psychological or ED-related terms, supplemented by cross-referencing. Inclusion criteria focused on empirical, theoretical, and clinically meaningful psychological, behavioural, and sociocultural outcomes, enabling a conceptually driven synthesis of the psychological effects of GLP-1RA use. Results: GLP-1RAs reduce hunger and binge-eating frequency, suggesting possible benefits for binge-type EDs. However, evidence for restrictive EDs remains limited, and appetite suppression may reinforce rigid control or perfectionistic traits. Although short-term reductions in emotional eating have been reported, the long-term psychological safety of GLP-1RAs is unknown. Rapid, medication-driven weight loss may disrupt body perception, while social media discourse glamorises thinness and intensifies stigma. These psychosocial effects intersect with inequities in access, disproportionately affecting adolescents and individuals from culturally diverse or socioeconomically marginalised groups. Conclusions: GLP-1RAs sit at the intersection of medical innovation and psychological risk. To ensure safe and inclusive use, research and clinical practice should integrate developmental, cultural, and lived-experience perspectives. Co-designed research and multidisciplinary monitoring will be essential to reduce stigma, address inequities, and support psychologically informed care. Full article

Dry eye disease (DED) is a highly prevalent multifactorial disorder of the ocular surface that extends beyond local tear film pathology to involve systemic immune, neuroendocrine, and neurosensory mechanisms. Increasing evidence reveals a strong and bidirectional association between DED and psychiatric disorders, particularly depression, anxiety, post-traumatic stress disorder (PTSD), and sleep disturbances. This review synthesises the current knowledge on shared molecular, neuroimmune, and neuropathic pathways that underlie this comorbidity. Key mechanisms include hypothalamic–pituitary–adrenal (HPA) axis dysregulation, systemic and ocular inflammation, oxidative stress, mitochondrial dysfunction, and impaired neurotrophic signaling, especially reduced brain-derived neurotrophic factor (BDNF). Dysregulation of monoaminergic neurotransmitters such as serotonin and norepinephrine not only contributes to mood disturbances but also alters tear secretion and corneal pain perception. Corneal nerve changes and trigeminal–limbic sensitisation further reinforce the overlap between neuropathic ocular pain and affective dysregulation. Psychotropic medications, while essential for psychiatric care, may exacerbate ocular surface dysfunction through anticholinergic effects, altered neurotransmission, and tear film instability, highlighting the iatrogenic dimension of this interface. Conversely, tear-based biomarkers, including cytokines, serotonin, and BDNF, offer promising translational tools for patient stratification, diagnosis, and treatment monitoring across ocular and psychiatric domains. Recognising DED as part of a systemic, biopsychosocial continuum is critical for effective management. Multidisciplinary strategies that integrate ophthalmologic and psychiatric care, alongside novel therapies targeting shared molecular pathways, provide a framework for improving outcomes. Future research should prioritise longitudinal studies, biomarker validation, and personalised interventions to address this complex comorbidity. Full article

Background/Objectives: Pain neuroscience education (PNE) has demonstrated efficacy in adults with chronic pain, but the pediatric evidence is still developing, despite its increasingly frequent use. Evidence for the effectiveness of PNE in pediatrics remains fragmented across settings and outcomes, which justifies a systematic evaluation focused on children and adolescents. Methods: Following PRISMA, two reviewers independently screened records (PubMed, Web of Science, PEDro; through 21 July 2025), extracted data, and assessed risk of bias (RoB 2 for randomized controlled trials; NIH/CASP for non-randomized studies). Given the heterogeneity, we conducted a structured narrative synthesis (SWiM) and rated the certainty of evidence with GRADE. PROSPERO: CRD420251062922. Results: Eleven studies met the inclusion criteria. PNE consistently improved pain-related knowledge, with effects maintained at follow-up (moderate certainty); effects on pain intensity, function, and emotional outcomes were small and inconsistent (low certainty), with more favorable patterns when PNE was combined with exercise and/or booster sessions. Digital and gamified formats proved feasible and engaging; parental outcomes showed small improvements where measured. Conclusions: PNE is a promising, low-cost, and scalable component of pediatric chronic pain care, strengthening self-efficacy and adaptive coping. Integration into biopsychosocial, multidisciplinary programs—particularly alongside exercise and family involvement—may optimize outcomes. Larger, standardized trials with long-term follow-up and systematic adverse-event reporting are needed to solidify guidance for clinical practice. Full article

Anxiety and depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which can contribute to increased morbidity, reduced quality of life, and worse clinical outcomes. Nevertheless, these psychological conditions remain largely overlooked. This narrative review includes studies published between 1983 and 2025 to synthesise the current evidence on the risk factors, clinical impacts, and therapeutic strategies for these comorbidities. While the exact mechanisms leading to their increased prevalence are not fully understood, growing evidence implicates a combination of biological (e.g., systemic inflammation), social (e.g., isolation and stigma), and behavioural (e.g., smoking and inactivity) factors. Despite current guidelines recommending the identification and management of these comorbidities in COPD, they are not currently included in COPD assessments. Undetected and unmanaged anxiety and depression have serious consequences, including poor self-management, non-adherence to medications, increased risk of exacerbation and hospitalisations, and even mortality; thus, there is a need to incorporate screening as part of COPD assessments. There is robust evidence showing that pulmonary rehabilitation, a core non-pharmacological intervention, can improve mood symptoms, enhance functional capacity, and foster psychosocial resilience. Psychological therapies such as cognitive behavioural therapy (CBT), mindfulness-based approaches, and supportive counselling have also demonstrated value in reducing emotional distress and improving coping mechanisms. Pharmacological therapies, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed in moderate to severe cases or when non-pharmacological approaches prove inadequate. However, the evidence for their efficacy in COPD populations is mixed, with concerns about adverse respiratory outcomes and high discontinuation rates due to side effects. There are also barriers to optimal care, including underdiagnosis, a lack of screening protocols, limited provider training, stigma, and fragmented multidisciplinary coordination. A multidisciplinary, biopsychosocial approach is essential to ensure early identification, integrated care, and improved outcomes for patients with COPD. Full article

Background: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, cognitive difficulties, and psychological symptoms. Patients often present distinct personality traits and psychopathological patterns associated with symptom severity. Objective: To examine psychopathological profiles in FM patients based on functional, physical–somatic, and emotional impairment domains, as well as on cumulative disease severity. Materials and Methods: A cross-sectional study was conducted with 70 women clinically diagnosed with FM at a specialized Fibromyalgia Unit. Psychological functioning was assessed using the Personality Assessment Inventory, and disease impact was measured with the Fibromyalgia Impact Questionnaire. Hierarchical cluster analyses were used to classify participants into mild and severe clusters across FIQ domains, and psychological profiles were compared. Results: Patients with severe functional impairment had more affective dysregulation (76.43 vs. 70.20, p < 0.01) and somatic complaints (85.57 vs. 79.76, p < 0.05) than those with mild impairment. The severe–physical cluster showed greater mood instability, somatization, and suicidal ideation (60.94 vs. 53.61, p < 0.05). The severe–emotional cluster had higher rates of major depression (85.71% vs. 64.28%) and persistent depressive disorder (76.19% vs. 70.61%, p < 0.05). Severe showed more emotional instability and somatization, distinguishing it from mild. Greater cumulative severity intensified depressive and somatic disorders. Discussion: Findings support FM’s biopsychosocial profile, where emotional distress may relate to psychological and physical symptoms, reinforcing the need for personalized, multidisciplinary care and comprehensive assessment. Full article