{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T08:54:39Z","timestamp":1771145679625,"version":"3.50.1"},"reference-count":100,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundac\u0327\u00e3o Grunenthal to the Faculty of Medicine of the University of Porto"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Fibromyalgia has unclear etiopathogenesis, no curative treatment, and a severe impact on the quality of life. Gratitude practices have been shown to enhance the quality of life in chronic diseases. This systematic review, performed by searching five electronic databases, following the PRISMA guidelines, is the first aiming to evaluate the impact of gratitude in fibromyalgia. Data from eligible studies was extracted and a narrative synthesis was performed. Six articles (four observational studies and two randomized clinical trials) were included. Higher levels of gratitude are associated with reduced symptom severity, an enhanced quality of life, improved well-being, and the improvement of pain-related outcomes in fibromyalgia patients. Gratitude is related to reduced stress, anxiety, and depression; better sleep patterns; and less functional impairment in FM patients. Higher levels of gratitude contribute to a better quality of life, general well-being, and higher functioning capacity in fibromyalgia patients. Based on the results gathered in this systematic review, we propose that gratitude should be investigated as a therapeutic adjuvant in the management of fibromyalgia.<\/jats:p>","DOI":"10.3390\/bs15081079","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T08:09:35Z","timestamp":1754640575000},"page":"1079","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can Gratitude Ease the Burden of Fibromyalgia? A Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3434-2247","authenticated-orcid":false,"given":"Bruno Daniel","family":"Carneiro","sequence":"first","affiliation":[{"name":"Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Rheumatology Service, Unidade Local de Sa\u00fade do Alto Minho, Hospital Conde de Bertiandos, 4990-078 Ponte de Lima, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-4479","authenticated-orcid":false,"given":"Daniel Humberto","family":"Pozza","sequence":"additional","affiliation":[{"name":"Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5696-1239","authenticated-orcid":false,"given":"Isaura","family":"Tavares","sequence":"additional","affiliation":[{"name":"Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"ref_1","first-page":"39","article-title":"Prevalence of fibromyalgia in the Israeli population: A population-based study to estimate the prevalence of fibromyalgia in the Israeli population using the London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ)","volume":"30","author":"Ablin","year":"2012","journal-title":"Clinical and Experimental Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e6307","DOI":"10.1002\/pon.6307","article-title":"Gratitude, optimism, and satisfaction with life and patient-reported outcomes in patients undergoing hematopoietic stem cell transplantation","volume":"33","author":"Amonoo","year":"2024","journal-title":"Psychooncology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.jpain.2018.10.008","article-title":"AAPT Diagnostic Criteria for Fibromyalgia","volume":"20","author":"Arnold","year":"2019","journal-title":"The Journal of Pain"},{"key":"ref_4","first-page":"3","article-title":"One year in review 2019: Fibromyalgia","volume":"37","author":"Atzeni","year":"2019","journal-title":"Clinical and Experimental Rheumatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"672","DOI":"10.3390\/curroncol31020049","article-title":"Positive psychological well-being in early palliative care: A narrative review of the roles of hope, gratitude, and death acceptance","volume":"31","author":"Bandieri","year":"2024","journal-title":"Current Oncology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2147\/JPR.S128508","article-title":"Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma","volume":"10","author":"Tanum","year":"2017","journal-title":"Journal of Pain Research"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"R120","DOI":"10.1186\/ar2783","article-title":"The Revised Fibromyalgia Impact Questionnaire (FIQR): Validation and psychometric properties","volume":"11","author":"Bennett","year":"2009","journal-title":"Arthritis Research & Therapy"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bennett, R. 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