Psychiatric disorders in patients with fibromyalgia. A multicenter investigation

• Published in: Psychosomatics (Washington, D.C.) Vol. 40; no. 1; pp. 57 - 63
• Main Authors: EPSTEIN, S. A, KAY, G, WAID, R, ZISOOK, S, CLAUW, D, HEATON, R, KLEIN, D, KRUPP, L, KUCK, J, LESLIE, V, MASUR, D, WAGNER, M
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Press 1999; Elsevier Limited
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Biological and medical sciences; Comorbidity; Diseases of the osteoarticular system; Female; Fibromyalgia - psychology; Fibromyalgia - rehabilitation; Humans; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - psychology; Middle Aged; Miscellaneous; Miscellaneous. Osteoarticular involvement in other diseases; Personality Inventory; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sick Role; Somatoform Disorders - diagnosis; Somatoform Disorders - psychology; Human; Striated muscle disease; Concomitant disease; Pain; Diseases of the osteoarticular system; Fibromyalgia; Mental disorder; Personality; Functional capacity
• ISSN: 0033-3182; 1545-7206
• DOI: 10.1016/S0033-3182(99)71272-7

The authors conducted an investigation in four tertiary-care centers to determine if psychiatric comorbidity and psychological variables were predictive of functional impairment in patients with fibromyalgia syndrome (FMS). Seventy-three individuals were administered the Structured Clinical Interview for DSM-III-R, the Rand 36-item Health Survey (SF-36), and multiple self-report measures. The patients with FMS were found to have a high lifetime and current prevalence of major depression and panic disorder. The most common disorders were major depression (lifetime [L] = 68%, current [C] = 22%); dysthymia (10% [C only]); panic disorder (L = 16%, C = 7%); and simple phobia (L = 16%, C = 12%). The self-report scales revealed significant elevations in depression, anxiety, neuroticism, and hypochondriasis. Functional impairment on all measures of the SF-36 was severe (e.g., physical functioning = 45.5 and role limitations due to physical problems = 20.0). Stepwise multiple-regression analysis revealed that current anxiety was the only variable that predicted a significant proportion of the variance (29%) in SF-36 physical functioning. Thus, in this multicenter study, the persons with FMS exhibited marked functional impairment, high levels of some lifetime and current psychiatric disorders, and significant current psychological distress. Current anxiety level appears to be an important correlate of functional impairment in individuals with FMS.