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

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.

CONCLUSION: Our data

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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