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Fibromyalgia and Depression

Abstract: Is there a connection between fibromyalgia and depression?

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Fibromyalgia and Depression

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Question(s): 
Written by: Martin Winkler
First version: 22 Jul 2008.
Latest revision: 23 Aug 2008.

Is there a connection between Fibromyalgia and Depression?
Are all patients with fibromyalgia depressed?

Answer:

Chronic pain caused by fibromyalgia syndrome can have a major influence on the quality of life. Depression and Fibromyalgia can be independ clincial disorders, but we often find a combination. Comorbid psychiatric disorders may have an influence on pain perception and activity. Impairments by the chronic pain and other symptoms of fibromyalgia can reduce social activities and contacts and may also have an influence on negative expectations concerning the own future and personal wellbeing. So there is often a relevant overlap of these two diagnoses. According to a study published in the Journal of Rheumatology in 2002 more than half of patients sended to a first diagnostic evaluation for fibromyalagia showed significant depressive symptoms in a clincial psychological interview. Depressed patients with FM were significantly more likely to
  • live alone
  • report elevated functional limitations
  • had negative or dysfunctional thoughts and expectations
  • had less access to physical therapy.
There was no significant differenc in pain severity, number of positive tender points or pain intensity in the group of depressed and non-depressed patients with fibromyalgia.

Discriminant analysis revealed that living status, the perception of functional limitations, maladaptive thoughts, and physical therapy treatment together identified diagnoses of depressive disorders for 78% of the patients.

Conclusion. Concurrent depressive disorders are prevalent in FM and may be independent of the cardinal features of FM, namely, pain severity and hypersensitivity to pressure pain, but are related to the cognitive appraisals of the effects of symptoms on daily life and functional activities.

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