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Psychiatric diagnoses in patients with fibromyalgia (FM) are related to health care-seeking behavior rather than to illness

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OBJECTIVE: To compare the frequency of lifetime psychiatric

disorders among 3 groups of subjects: patients with

fibromyalgia syndrome (FMS) from a tertiary care setting,

community residents with FMS who had not sought medical care

for their FMS symptoms (“FMS nonpatients”), and healthy


METHODS: We used the Computerized Diagnostic

Interview Schedule to assess lifetime psychiatric diagnoses,

as well as the Center for Epidemiological Studies Depression

scale and the Trait Anxiety Inventory to assess current

psychological distress, among 64 patients with FMS, 28 FMS

nonpatients, and 23 healthy individuals.

RESULTS: Patients

with FMS, relative to FMS nonpatients and healthy controls,

were characterized by a significantly greater number of

lifetime psychiatric diagnoses (P = 0.002). Nonpatients did

not differ from controls in psychiatric diagnoses. Patients

also exhibited higher psychological distress levels than

nonpatients, and nonpatients showed greater distress than

controls. Differences in psychological distress between

patients and nonpatients were eliminated after controlling for

pain threshold and fatigue ratings.

CONCLUSION: Psychiatric

disorders are not intrinsically related to the FMS syndrome.

Instead, multiple lifetime psychiatric diagnoses may

contribute to the decision to seek medical care for FMS in

tertiary care settings.

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