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Fibromyalgia (FM), depression, & alcoholism: a family history study

  [ 35 votes ]   [ Discuss This Article ] • January 25, 1996

OBJECTIVE: Fibromyalgia (FM) syndrome may be part of an "affective
spectrum disorder." The diseases in this group have in common
high rates of major depression in first degree relatives
(FDR) and a response to antidepressant treatment. In this
familial aggregation study, we tested the hypothesis that
depression in patients with FM is related to a family history
of depression or alcoholism in their FDR.

METHODS: To assess
the relationship between FM and lifetime histories of
depression (DEP) and alcoholism (ALC), personal and family
histories of mood and substance use disorders were obtained
from 60 probands with FM. DEP and ALC among the probands were
diagnosed using the Schedule for Affective Disorders and
Schizophrenia, a standardized, structured psychiatric
interview, and the Research Diagnostic Criteria (RDC). Family
psychopathology in the FDR (parents, full siblings, children)
was assessed using the Family History RDC. The odds ratio
(OR) for DEP and/or ALC in FDR of probands with a history of
DEP versus those without DEP were calculated. Confidence
intervals (CI) not including 1 were significant at p < 0.05
(95% CI).

RESULTS: The odds of identifying FDR with DEP
and/or ALC were significantly higher among probands with FM
with a lifetime history of DEP than among probands with FM
who had no history of DEP (OR = 2.10, 95% CI = 1.23-3.57).
This may be accounted for by the significantly higher odds
for ALC among the FDR of probands with both FM and DEP
compared with the FDR of probands with FM but no history of
depression (OR = 2.30, 95% CI = 1.21-4.37). Although
alcoholism was increased in the FDR of probands with FM with
a history of depression, the odds for DEP were
nonsignificantly higher among these FDR (OR = 1.71, 95% CI =
0.87-3.31). OR in the same range of magnitude were obtained
when the data were analyzed by family unit, but these results
were not statistically significant.

suggest that the tendency toward DEP in patients with FM may
be a manifestation of a familial depressive spectrum disorder
(alcoholism and/or depression in the family members), not
simply a "reactive" depression secondary to the pain and
other symptoms.

MCM: Tendency toward depression in FM is a manifestation of a
familial depressive spectrum disorder.

Katz RS, Kravitz HM

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