Evaluation of the relationship between depression and fibromyalgia syndrome:
why aren't all patients depressed
by
Okifuji A, Turk DC, Sherman JJ
Department of Anesthesiology,
University of Washington,
Seattle 98195, USA.
J Rheumatol 2000 Jan; 27(1):212-9
ABSTRACT
OBJECTIVE: To examine the relationship between fibromyalgia syndrome (FM) and
depression by determining the set of factors that differentiate FM patients with
and without depressive disorders. METHODS: A sample of 69 patients with FM
underwent a standardized tender point examination and a semistructured
psychological interview and completed a set of self-report inventories. RESULTS:
Of the sample, 39 met criteria for depressive disorder and 30 did not. Depressed
patients with FM were significantly more likely to live alone, report elevated
functional limitations, and display maladaptive thoughts than nondepressed
patients. Nondepressed patients were significantly more likely to have received
prior physical therapy than depressed patients. Pain severity, numbers of
positive tender points, and pain intensity of tender points and control points
did not differentiate the depressed and nondepressed patients. Discriminant
analysis revealed that living status, the perception of functional limitations,
maladaptive thoughts, and physical therapy treatment together identified
diagnoses of depressive disorders for 78% of the patients. CONCLUSION:
Concurrent depressive disorders are prevalent in FM and may be independent of
the cardinal features of FM, namely, pain severity and hypersensitivity to
pressure pain, but are related to the cognitive appraisals of the effects of
symptoms on daily life and functional activities.
5-HTP
Opioids
Cocaine
Cannabis
Gabapentin
Hyperalgesia
Amphetamine
Buprenorphine
Antidepressants
Treating pain seriously
The pain of fibromyalgia
Enkephalinase inhibitors
Venlafaxine (Effexor) for fibromyalgia
Duloxetine (Cymbalta) for fibromyalgia/depression
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