Hudson J I, Goldenberg D L, Pope H G, Keck P E, Schlesinger L
Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts 02178.
Am J Med. 1992 Apr;92(4):363-7. doi: 10.1016/0002-9343(92)90265-d.
Patients with fibromyalgia have been reported to display high rates of several concomitant medical and psychiatric disorders, including migraine, irritable bowel syndrome, chronic fatigue syndrome, major depression, and panic disorder. To test further these and other possible associations, we assessed the personal and family histories of a broad range of medical and psychiatric disorders in patients with fibromyalgia.
Subjects were 33 women (mean age 42.1 years) who each met American College of Rheumatology criteria for fibromyalgia and presented to a rheumatologist at a tertiary referral center. They received the Structured Clinical Interview for DSM-III-R (SCID); a supplemental interview, in SCID format, for other medical and psychiatric disorders, including migraine, irritable bowel syndrome, and chronic fatigue syndrome; and an interview for family history of medical and psychiatric disorders.
Patients with fibromyalgia displayed high lifetime rates of migraine, irritable bowel syndrome, chronic fatigue syndrome, major depression, and panic disorder. They also exhibited high rates of familial major mood disorder.
The finding that migraine, irritable bowel syndrome, chronic fatigue syndrome, major depression, and panic disorder are frequently comorbid with fibromyalgia is consistent with the hypothesis that these various disorders may share a common physiologic abnormality.
据报道,纤维肌痛患者患有多种伴发的医学和精神疾病的比例较高,包括偏头痛、肠易激综合征、慢性疲劳综合征、重度抑郁症和惊恐障碍。为了进一步检验这些以及其他可能的关联,我们评估了纤维肌痛患者广泛的医学和精神疾病的个人史和家族史。
研究对象为33名女性(平均年龄42.1岁),她们均符合美国风湿病学会纤维肌痛标准,并在一家三级转诊中心就诊于一名风湿病专家。她们接受了针对《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)的结构化临床访谈(SCID);以SCID格式进行的关于其他医学和精神疾病(包括偏头痛、肠易激综合征和慢性疲劳综合征)的补充访谈;以及关于医学和精神疾病家族史的访谈。
纤维肌痛患者偏头痛、肠易激综合征、慢性疲劳综合征、重度抑郁症和惊恐障碍的终生患病率较高。他们还表现出家族性重度情绪障碍的高患病率。
偏头痛、肠易激综合征、慢性疲劳综合征、重度抑郁症和惊恐障碍常与纤维肌痛共病这一发现与这些不同疾病可能共享一种常见生理异常的假说一致。