Individuals with fibromyalgia are at greater risk for depressive symptoms than the general population, and this may be partially attributable to physical symptoms that impair day-to-day functioning. However, individual-level protective characteristics may buffer risk for psychopathology. For instance, the ability to perceive a "silver lining" in one`s illness may be related to better mental and physical health. We examined perceived silver lining as a potential moderator of the relation between fibromyalgia impact and depressive symptoms. Our sample of persons with fibromyalgia (N = 401) completed self-report measures including the Fibromyalgia Impact Questionnaire-Revised, Depression Anxiety Stress Scales, and the Silver Lining Questionnaire. Moderation analyses covaried age, sex, and ethnicity. Supporting hypotheses, increasing impact of disease was related to greater depressive symptoms, and perceptions of a silver lining attenuated that association. Despite the linkage between impairment and depressive symptoms, identifying positive aspects or outcomes of illness may reduce risk for psychopathology. Therapeutically promoting perception of a silver lining, perhaps via signature strengths exercises or a blessings journal, and encouraging cognitive reframing of the illness experience, perhaps via Motivational Interviewing or Cognitive Behavioral Therapy, may reduce depressive symptoms in persons with fibromyalgia.

(1) Background: Mind-body interventions (MBI), such as meditation or other relaxation techniques, have become the focus of attention in the clinical and health sciences. Differences in the effects of induction techniques are being increasingly investigated. (2) Methods: Here, we compared changes in the individual experience of time, space, and self in 44 students in an integrative health-promotion program. They participated in a study employing mindfulness meditation and a relaxation intervention with one week between sessions, thus employing a within-subjects design. (3) Results: No significant differences were detected when subjective reports were compared directly after each intervention. However, we found significant sequence effects between t1 and t2, independent of the meditation type. The sense of self diminished, the present orientation increased, and the past and future orientations decreased in both interventions. (4) Conclusions: We propose using scales to assess subjective time, self, and space as basic constituents of experience to measure the specificity of intervention methods, as well as longitudinal changes.

Background Sleep problems and fatigue are very common in rheumatic diseases and painful conditions. There is mounting evidence that sleep problems and fatigue have reciprocal influences on musculoskeletal pain, mood, and overall well-being of patients with rheumatic disorders. In addition, sleeping problems are a risk factor for developing chronic widespread pain.Objectives To assess and compare sleep problems and fatigue in a cohort of patients with AS, RA and FM.Methods We conducted an online survey with patients regularly attending the Gastein Healing Galleries in Bad Gastein, Austria. In this health facility appr. 12,000 patients with a variety of disease are being treated annually. Of those, 6,465 patients were invited by email to fill out the survey anonymously. Sociodemographics and disease related variables (e.g. pain, depression) were assessed, including current health status, three items concerning sleep quality, duration of sleep problems, and the number of nights affected by sleep problems, and four items from the Multidimensional Fatigue Inventory (general fatigue subscale) concerning feeling fit, tired, rested, and tiring easily.Results In total 2,017 patients responded (=31%) of which a subset of 784 respondents indicated a diagnosis of AS (43%), RA (40%), or FM (17%). Their mean age (SD) was 58 years (11) and 53% were male. Level of education was: Elementary School 30%, Junior High School 22%, High School 20%, College 13%, and University 15%. Only 17% of AS, 20% of RA and 12% of FM patients indicated that their sleep quality is not affected. In 51.6% of AS, 47.2% of RA and 64% of FM patients the duration of the sleeping problem persists more than one year. Examining levels of sleep problems and fatigue across these three groups revealed significant variation (p<.001). Regarding sleep problems, FM patients showed significantly higher levels of problems than AS (p<.001) and RA patients (p<.001), and the latter two groups do not significantly differ. FM patients reported significantly higher levels of fatigue than AS (p<.001) and RA patients (p<.001), and AS patients had significantly higher levels of fatigue than RA patients (p<.001). Fatigue and sleep problems were correlated in expected directions with depression, pain, and health. However, while there was little variability in the magnitude of the associations between fatigue and sleep problems with depression and pain, there was considerable variation in the association of fatigue and sleep problems with health. AS patients showed a small and non-significant association, whereas, RA patients showed a larger association (r˜.20) and FM patients showed the largest association (r˜.5).Conclusion We found sleep problems and fatigue to be common, chronic and elevated in AS, RA and FM, but not equally so across diagnostic categories. FM patients showed the greatest problems with sleep and fatigue. Furthermore, it appears that fatigue and sleep problems may have the most important connection to health for FM patients. To conclude, it is important to address sleep problems and fatigue in routine clinical assessment and management of patients with AS, RA and FM.Disclosure of Interests None declared

Background: Patient education is an important part of the management of rheumatic and other diseases. Since patients do not have the same needs, it is crucial to assess needs of a targeted group to be able to tailor educational interventions.Objectives: To assess educational needs of a large cohort of patients with different rheumatic and musculoskeletal diseases attending a health facility in Austria.Methods: We conducted an online survey with patients attending the Gastein Healing Galleries in Bad Gastein, Austria. Approximately 12,000 patients with a variety of diseases are treated in the centre every year. Of those, 6,465 patients were invited by email to fill out an anonymous online survey. Socio-demographics and health outcomes were collected from all respondents. In addition, the Educational Needs Assessment Tool (Austrian version - OENAT) was administered to a subset of respondents. The OENAT (39 items) assesses 7 domains of educational needs: Managing Pain, Movement, Managing Feelings, Arthritis/Disease process, Treatments, Self Help Measures, Support Systems.Results: In total 2017 (31%) patients responded of which 516 had data on educational needs: AS (63%), RA (14%), and FM (24%). Their mean (SD) age was 56 (11), and 54% were male. Level of education was: Elementary School (32%), Junior High School (22%), High School (21%), College (12%), and University (14%). Table 1 presents differences in educational needs across disease groups. Across the groups, there were significant differences in following OENAT domains: Managing Pain, Feelings, Treatments, and Support Systems. There were no differences in the level of educational needs in Movements, Disease Process, and Self-Help Measures. Patients with FM had significantly lower needs for managing and higher needs for feeling education, compared to those with AS and RA (p<.05). The RA group had significantly higher needs than the AS (p<.05) and FM (p<.05) groups for treatments education - the AS group had significantly higher needs than the FM group (p<.05) in the same domain. AS patients had significantly higher needs for support system education than FM (p<.05) and RA patients (p<.05).View this table:Table 1 Differences in educational needs across disease groupsConclusion: Educational needs vary by disease groups and depend on the domain under consideration. Disclosure of Interests: None declared