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

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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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