Abstract
BackgroundMood disorders were found associated with fibromyalgia (FM) and clinical studies have revealed the efficacy of antidepressant drugs in the treatment of FM. However no specific instruments to identify manic symptoms were used.ObjectivesTo assess the frequency of anxiety and mood disorders (particularly bipolar disorders and manic symptoms) in a consecutive sample of women affected by FM using standardized diagnostic tools and to compare the prevalence of these disorders with that observed in a sample of healthy controls from the general population.MethodsCases: consecutive series of women (N = 37, mean age 50.1 ± 21.0) attending a Rheumatology outpatient Unit at the University of Cagliari. Controls: 148 women, drawn from the data bank of an epidemiological study matched for sex and age with controls according to a randomisation "after blocks" method. The Italian version of the Composite International Diagnostic Interview Simplified were carried out by physicians. Psychiatric diagnosis was formulated according to DSM-IV criteria. The Italian version of the Mood Disorder Questionnaire (MDQ) was administered to identify manic symptoms and bipolar disorders. Diagnosis of FM were carried out by rheumatologist according to the criteria of American College of Rheumatology.ResultsSubjects with FM showed a higher comorbidity with Generalised Anxiety Disorder, Panic Disorder and Major Depressive Disorder than controls. The study showed a high frequency of manic symptoms (MDQ positive) in the sample of fibromyalgic patients (59%), approximately double that found in the control sample (P < 0.001).DiscussionClinical studies have shown the efficacy of antidepressants, especially tricyclic antidepressants, in the treatment of FM. The clinical difficulty in identifying hypomanic episodes is well known particularly where previous and not present episodes are concerned as in depressive patients. These data would suggest further studies on the subject are needed and more caution also in prescribing antidepressants in a population apparently at high risk for bipolar disorders.
Highlights
Mood disorders were found associated with fibromyalgia (FM) and clinical studies have revealed the efficacy of antidepressant drugs in the treatment of FM
Several studies, reported high frequency of mood disorders in subjects affected by fibromyalgia (FM) [1,2] and short term clinical studies have revealed the efficacy of antidepressant drugs in the treatment of FM [3]
The aim of this study is to assess the frequency of anxiety and mood disorders in a consecutive sample of women affected by FM using standardized diagnostic tools administered by clinicians and to compare the prevalence of these disorders with that observed in a sample of healthy controls from the general population
Summary
Mood disorders were found associated with fibromyalgia (FM) and clinical studies have revealed the efficacy of antidepressant drugs in the treatment of FM. No specific instruments to identify manic symptoms were used. Several studies, reported high frequency of mood disorders in subjects affected by fibromyalgia (FM) [1,2] and short term clinical studies have revealed the efficacy of antidepressant drugs in the treatment of FM [3]. No specific instruments to identify manic symptoms were used in these studies. By means of specific tools such as the Mood Disorder Questionnaire [11]. A comparison of familiarity for mood disorders will be performed between cases and healthy controls Bipolar Disorders (BD) are renowned to be hard to distinguished by Major Depressive Disorders in research studies when using "traditional" psychiatric diagnostic tools such as interviews carried out by lay interviewer and not by clinicians [4].
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