{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:11:42Z","timestamp":1770289902292,"version":"3.49.0"},"reference-count":46,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gobierno de Extremadura- Fondo Europeo de Desarrollo Regional, Spain","award":["GR21079"],"award-info":[{"award-number":["GR21079"]}]},{"name":"Gobierno de Extremadura- Fondo Europeo de Desarrollo Regional, Spain","award":["TE-0027-19"],"award-info":[{"award-number":["TE-0027-19"]}]},{"name":"Autonomous Community of Extremadura","award":["GR21079"],"award-info":[{"award-number":["GR21079"]}]},{"name":"Autonomous Community of Extremadura","award":["TE-0027-19"],"award-info":[{"award-number":["TE-0027-19"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are two diseases that are frequently codiagnosed and present many similarities, such as poor tolerance to physical exercise. Although exercise is recommended in their daily routine to improve quality of life, little is known about how CFS codiagnosis affects that. Using scientifically validated questionnaires, we evaluated the psychological state and quality of life of patients with FM (n = 70) and how habitual physical exercise (HPE) reported by patients with only FM (FM-only n = 38) or codiagnosed with CFS (FM + CFS, n = 32) influences those aspects. An age-matched reference group of \u201chealthy\u201d women without FM (RG, n = 70) was used. The FM-only group presented a worse psychological state and quality of life compared to RG, with no influence of CFS codiagnosis. The patients of the FM-only and FM + CFS groups who perform HPE presented better levels of stress and state anxiety, but with no differences between them. Depression and trait anxiety improved only in women with just FM. CFS codiagnosis does not worsen the psychological and quality of life impairment of FM patients and does not have a great influence on the positive effect of HPE.<\/jats:p>","DOI":"10.3390\/jcm11195735","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T22:53:19Z","timestamp":1664405599000},"page":"5735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Influence of Codiagnosis of Chronic Fatigue Syndrome and Habitual Physical Exercise on the Psychological Status and Quality of Life of Patients with Fibromyalgia"],"prefix":"10.3390","volume":"11","author":[{"given":"Mar\u00eda Dolores","family":"Hinchado","sequence":"first","affiliation":[{"name":"Immunophyisiology Research Group, Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), Av. de Elvas s\/n, 06080 Badajoz, Spain"},{"name":"Immunophysiology Research Group, Physiology Department, Faculty of Sciences, University of Extremadura, 06071 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6445-5114","authenticated-orcid":false,"given":"Eduardo","family":"Otero","sequence":"additional","affiliation":[{"name":"Immunophyisiology Research Group, Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), Av. de Elvas s\/n, 06080 Badajoz, Spain"},{"name":"Immunophysiology Research Group, Physiology Department, Faculty of Sciences, University of Extremadura, 06071 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7046-9734","authenticated-orcid":false,"given":"Mar\u00eda del Carmen","family":"Navarro","sequence":"additional","affiliation":[{"name":"Immunophyisiology Research Group, Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), Av. de Elvas s\/n, 06080 Badajoz, Spain"},{"name":"Immunophysiology Research Group, Physiology Department, Faculty of Sciences, University of Extremadura, 06071 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3651-2265","authenticated-orcid":false,"given":"Leticia","family":"Mart\u00edn-Cordero","sequence":"additional","affiliation":[{"name":"Immunophyisiology Research Group, Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), Av. de Elvas s\/n, 06080 Badajoz, Spain"},{"name":"Immunophysiology Research Group, Nursing Department, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4294-4507","authenticated-orcid":false,"given":"Isabel","family":"G\u00e1lvez","sequence":"additional","affiliation":[{"name":"Immunophyisiology Research Group, Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), Av. de Elvas s\/n, 06080 Badajoz, Spain"},{"name":"Immunophysiology Research Group, Nursing Department, Faculty of Medicine and Health Sciences, University of Extremadura, 06071 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7007-7615","authenticated-orcid":false,"given":"Eduardo","family":"Ortega","sequence":"additional","affiliation":[{"name":"Immunophyisiology Research Group, Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), Av. de Elvas s\/n, 06080 Badajoz, Spain"},{"name":"Immunophysiology Research Group, Physiology Department, Faculty of Sciences, University of Extremadura, 06071 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1136\/annrheumdis-2016-209724","article-title":"EULAR Revised Recommendations for the Management of Fibromyalgia","volume":"76","author":"Macfarlane","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s10067-015-3144-2","article-title":"A Meta-Analysis to Determine the Effect of Pharmacological and Non-Pharmacological Treatments on Fibromyalgia Symptoms Comprising OMERACT-10 Response Criteria","volume":"35","author":"Papadopoulou","year":"2016","journal-title":"Clin. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1016\/j.apmr.2015.03.015","article-title":"Association of Physical Fitness with Fibromyalgia Severity in Women: The Al-\u00c1ndalus Project","volume":"96","author":"Henriksen","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1002\/1529-0131(200012)13:6<343::AID-ART3>3.0.CO;2-P","article-title":"Fibromyalgia, Physical Activity, and Daily Functioning: The Importance of Efficacy and Health-Related Quality of Life","volume":"13","author":"Brawley","year":"2000","journal-title":"Arthritis Care Res."},{"key":"ref_5","first-page":"42","article-title":"Exercise in Fibromyalgia and Related Inflammatory Disorders: Known Effects and Unknown Chances","volume":"15","author":"Ortega","year":"2009","journal-title":"Exerc. Immunol. Rev."},{"key":"ref_6","first-page":"159","article-title":"Evidence-Based Recommendations for Physical Activity in Women with Fibromyalgia","volume":"3","author":"Galiano","year":"2010","journal-title":"Rev. Andaluza Med. del Deport."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1159\/000341664","article-title":"Inflammatory\/Stress Feedback Dysregulation in Women with Fibromyalgia","volume":"19","author":"Bote","year":"2012","journal-title":"Neuroimmunomodulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.bbi.2013.11.009","article-title":"An Exploratory Study of the Effect of Regular Aquatic Exercise on the Function of Neutrophils from Women with Fibromyalgia: Role of IL-8 and Noradrenaline","volume":"39","author":"Bote","year":"2014","journal-title":"Brain. Behav. Immun."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1519\/SSC.0b013e31818eb19a","article-title":"Training Individuals with Chronic Fatigue Syndrome","volume":"30","author":"Dawes","year":"2008","journal-title":"Strength Cond. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1001\/archinte.160.2.221","article-title":"Overlapping Conditions Among Patients With Chronic Fatigue Syndrome, Fibromyalgia, and Temporomandibular Disorder","volume":"160","author":"Aaron","year":"2000","journal-title":"Arch. Intern. Med."},{"key":"ref_11","first-page":"584573","article-title":"The Prevalence of Fibromyalgia in Other Chronic Pain Conditions","volume":"2012","author":"Yunus","year":"2012","journal-title":"Pain Res. Treat."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1249\/MSS.0b013e3182417b9a","article-title":"Responses to Exercise Differ for Chronic Fatigue Syndrome Patients with Fibromyalgia","volume":"44","author":"Cook","year":"2012","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_13","first-page":"CD003200","article-title":"Exercise Therapy for Chronic Fatigue Syndrome","volume":"2017","author":"Larun","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1600-0838.2010.01132.x","article-title":"Aquatic Exercise Improves the Monocyte Pro- and Anti-Inflammatory Cytokine Production Balance in Fibromyalgia Patients","volume":"22","author":"Ortega","year":"2012","journal-title":"Scand. J. Med. Sci. Sport."},{"key":"ref_15","first-page":"904","article-title":"Evolution and Scientific Impact of Research Grants From the Spanish Society of Cardiology and Spanish Heart Foundation (2000\u20132006)","volume":"64","author":"Heras","year":"2011","journal-title":"Rev. Espa\u00f1ola Cardiol. Engl. Ed."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.aprim.2010.07.008","article-title":"Prevalence, Awareness, Treatment and Control of Cardiovascular Risk Factors in the Extremadura Population (Spain). HERMEX Study","volume":"43","author":"Zaro","year":"2011","journal-title":"Aten. Primaria"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 Fibromyalgia Diagnostic Criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"953","DOI":"10.7326\/0003-4819-121-12-199412150-00009","article-title":"The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study","volume":"121","author":"Fukuda","year":"1994","journal-title":"Ann. Intern. Med."},{"key":"ref_19","first-page":"561","article-title":"An Inventory for Measuring Depression, Archives of General","volume":"4","author":"Beck","year":"1961","journal-title":"Psychiatry"},{"key":"ref_20","first-page":"249","article-title":"The Spanish Adaptation of Beck\u2019s Depression Inventory-II (BDI-II): 2. Psychometric Properties in the General Population","volume":"14","author":"Sanz","year":"2003","journal-title":"Clin. y Salud"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A Global Measure of Perceived Stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1017\/S1138741600006004","article-title":"Psychometric Properties of a European Spanish Version of the Perceived Stress Scale (PSS)","volume":"9","author":"Remor","year":"2006","journal-title":"Span. J. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Spielberger, C.D. (1983). State-Trait Anxiety Inventory for AdultsTM, APA PsycTests.","DOI":"10.1037\/t06496-000"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.ijchp.2017.07.003","article-title":"Short Form of the Spanish Adaptation of the State-Trait Anxiety Inventory","volume":"17","year":"2017","journal-title":"Int. J. Clin. Health Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/0304-3959(83)90143-4","article-title":"Development of the Wisconsin Brief Pain Questionnaire to Assess Pain in Cancer and Other Diseases","volume":"17","author":"Daut","year":"1983","journal-title":"Pain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jphys.2015.07.001","article-title":"The Brief Pain Inventory (BPI)","volume":"62","author":"Poquet","year":"2016","journal-title":"J. Physiother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0025-7753(03)73601-X","article-title":"Validaci\u00f3n Espa\u00f1ola Del Cuestionario Brief Pain Inventory En Pacientes Con Dolor de Causa Neopl\u00e1sica","volume":"120","author":"Badia","year":"2003","journal-title":"Med. Clin."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1002\/(SICI)1097-0142(19990301)85:5<1186::AID-CNCR24>3.0.CO;2-N","article-title":"The Rapid Assessment of Fatigue Severity in Cancer Patients: Use of the Brief Fatigue Inventory","volume":"85","author":"Mendoza","year":"1999","journal-title":"Cancer"},{"key":"ref_29","unstructured":"Valenzuela, J.O., Gning, I., Irarr\u00e1zaval, M.E., Fasce, G., Mar\u00edn, L., Mendoza, T.R., Palos, G., Reynolds, R., Wang, X.S., and Cleeland, C.S. (2022, January 24). Psychometric Validation of the Spanish Version of the Brief Fatigue Inventory [abstract] The University of Texas MD Anderson Cancer Center, Division of Internal Medicine Research Retreat, Houston, TX, USA, 24 May 2012. Available online: https:\/\/www.mdanderson.org\/research\/departments-labs-institutes\/departments-divisions\/symptom-research\/symptom-assessment-tools\/brief-fatigue-inventory.html."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Darviri, C., Alexopoulos, E.C., Artemiadis, A.K., Tigani, X., Kraniotou, C., Darvyri, P., and Chrousos, G.P. (2014). The Healthy Lifestyle and Personal Control Questionnaire (HLPCQ): A Novel Tool for Assessing Self-Empowerment through a Constellation of Daily Activities. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-995"},{"key":"ref_31","first-page":"728","article-title":"The Fibromyalgia Impact Questionnaire: Development and Validation","volume":"18","author":"Burckhardt","year":"1991","journal-title":"J. Rheumatol."},{"key":"ref_32","first-page":"554","article-title":"The Fibromyalgia Impact Questionnaire: A Validated Spanish Version to Assess the Health Status in Women with Fibromyalgia","volume":"22","author":"Rivera","year":"2004","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1080\/07481187.2020.1748481","article-title":"Coronavirus Anxiety Scale: A Brief Mental Health Screener for COVID-19 Related Anxiety","volume":"44","author":"Lee","year":"2020","journal-title":"Death Stud."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.regg.2021.09.001","article-title":"Measurement of Coronaphobia in Older Adults: Validation of the Spanish Version of the Coronavirus Anxiety Scale","volume":"57","author":"Vilca","year":"2022","journal-title":"Rev. Esp. Geriatr. Gerontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1007\/s11469-020-00270-8","article-title":"The Fear of COVID-19 Scale: Development and Initial Validation","volume":"20","author":"Lin","year":"2022","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_36","first-page":"96","article-title":"The COVID-19 Fear Scale (FCV-19S): Psychometric Properties and Invariance of the Measure in the Spanish Version","volume":"49","year":"2021","journal-title":"Actas Esp. Psiquiatr."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Bote, M.E., Garcia, J.J., Hinchado, M.D., and Ortega, E. (2013). Fibromyalgia: Anti-Inflammatory and Stress Responses after Acute Moderate Exercise. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0074524"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/s12016-015-8509-4","article-title":"Fibromyalgia: A Critical and Comprehensive Review","volume":"49","author":"Borchers","year":"2015","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.medcli.2013.06.030","article-title":"Impact of the Fibromyalgia in the Chronic Fatigue Syndrome","volume":"142","author":"Faro","year":"2014","journal-title":"Med. Clin."},{"key":"ref_40","first-page":"548","article-title":"Effect of a Physical Activity Programme in Patients with Fibromyalgia: A Systematic Review","volume":"143","year":"2014","journal-title":"Med. Clin."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1136\/bjsports-2017-098407","article-title":"Exercise Therapy Is a Beneficial Intervention for Chronic Fatigue Syndrome (PEDro Synthesis)","volume":"52","author":"Dannaway","year":"2018","journal-title":"Br. J. Sports Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.mayocpiqo.2020.08.002","article-title":"Fibromyalgia and Chronic Fatigue Syndrome in the Age of COVID-19","volume":"4","author":"Mohabbat","year":"2020","journal-title":"Mayo Clin. Proc. Innov. Qual. Outcomes"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"72","DOI":"10.55563\/clinexprheumatol\/dnxtch","article-title":"The Effect of Novel Coronavirus Disease-2019 (COVID-19) on Fibromyalgia Syndrome","volume":"39","author":"Salaffi","year":"2021","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s42358-021-00200-9","article-title":"The Effects of COVID-19 Fear and Anxiety on Symptom Severity, Sleep Quality, and Mood in Patients with Fibromyalgia: A Pilot Study","volume":"61","author":"Cankurtaran","year":"2021","journal-title":"Adv. Rheumatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1590\/1806-9282.20210122","article-title":"COVID-19 Pandemic and Exercising: A Cross-Sectional Study with 1156 Patients with Fibromyalgia","volume":"67","author":"Martins","year":"2021","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/s13075-018-1671-3","article-title":"Physical Activity Is Related to Function and Fatigue but Not Pain in Women with Fibromyalgia: Baseline Analyses from the Fibromyalgia Activity Study with TENS (FAST)","volume":"20","author":"Merriwether","year":"2018","journal-title":"Arthritis Res. Ther."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5735\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:56Z","timestamp":1760143256000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,28]]},"references-count":46,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11195735"],"URL":"https:\/\/doi.org\/10.3390\/jcm11195735","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,28]]}}}