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Psychosocial factors in fibromyalgia (FM) compared with RA: I. Psychiatric diagnoses & functional disability

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By Walker EA, Keegan D, Gardner G, Sullivan M, Katon WJ, Bernstein D • www.ProHealth.com • November 12, 1997


OBJECTIVE: Recent studies of the relationship between
fibromyalgia and psychiatric disorders have yielded
conflicting findings, and many of these inconsistencies seem
to result from methodological differences.
METHOD: We compared
36 patients with fibromyalgia and 33 patients with rheumatoid
arthritis from a tertiary care clinic using
physician-administered, structured psychiatric interviews and
self-reported measures of illness appraisal, coping, and
functional disability.
RESULTS: Patients with fibromyalgia had
significantly higher lifetime prevalence rates of mood and
anxiety disorders, as well as higher mean numbers of medically
unexplained physical symptoms across several organ systems.
Ninety percent of the patients with fibromyalgia had a prior
psychiatric diagnosis compared with less than half of the
patients with rheumatoid arthritis.
CONCLUSIONS: Despite the
absence of organic pathology, the patients with fibromyalgia
had equal or greater functional disability and were less well
adapted to their illness. Although the pathophysiology of
fibromyalgia remains unclear, co-morbid psychiatric disorders
and functional disability remain an important focus of
treatment in this population.




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