In patients with fibromyalgia, a systematic review found higher rates of chronic pain and mood disorders and lower rates of anxiety-related illness. These results were published in seminars on arthritis and rheumatism.
Through July 11, 2019, publication databases were searched for studies linking fibromyalgia to chronic pain and psychiatric comorbidities. A total of 31 studies were selected for this review.
The included cross-sectional design studies were published between 1992 and 2018. The sample sizes ranged from 22 to 509 with a high tendency towards women (80%). Psychiatric studies have been conducted in 7 countries, mainly Italy and the United States. The quality of studies assessed by the Joanna Briggs Institute’s Critical Assessment Checklist for Prevalence Studies was 4 out of 7, with the ratio of quality to risk of bias totaling 0.57.
The studies examined anxiety disorders (n = 16), mood disorders (n = 14), or personality disorders (n = 2). In general, lifelong mood disorders were more common (depression) [63.0%], Depression [52.3%]and bipolar [26.2%]) versus anxiety disorder (panic disorder [33.0%]Agoraphobia [12.0%], post-traumatic stress disorder [16.1%]and generalized anxiety disorder [9.10%]).
The most common chronic pain reports reported were lifelong temporomandibular disorders (57.0%), followed by migraines (56.0%), chronic tension-type headaches (48.0%), irritable bowel syndrome (44.0%), and lower pain Back area (39.0%)).
The rates for lifelong cases were higher compared to current comorbid conditions, with the exception of social phobia (14.0% vs 17.7%), post-traumatic stress disorder (16.1% vs 39.1%), and irritable bowel syndrome (44.0 % versus 45.0%).
This study was limited by the underlying studies, which tended to have low sample sizes (N <100) and a predominantly female bias. The most recent diagnostic criteria for fibromyalgia have been updated to reduce underdiagnosis in men. However, these criteria were not implemented in these studies.
The review authors concluded that patients with fibromyalgia had an increased rate of psychiatric depression and major depression disorders, as well as TMJ disorders, migraine headaches, and irritable bowel syndrome, highlighting the importance of evaluating patients with fibromyalgia for comorbid conditions.
Disclosure: Several authors have declared their affiliations with the industry. For a full list of the details, see the original article.
Kleykamp BA, Ferguson MC, McNicol E. et al. The prevalence of psychiatric and chronic pain comorbidities in fibromyalgia: a systematic review of ACTTION. Semin Arthritis Rheumatism. 2020; 51 (1): 166-167; 174. doi: 10.1016 / j.semarthrit.2020.10.006
This article originally appeared on Clinical Pain Advisor