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纤维肌痛女性社区样本中的精神共病情况。

Psychiatric comorbidities in a community sample of women with fibromyalgia.

作者信息

Raphael Karen G, Janal Malvin N, Nayak Sangeetha, Schwartz Joseph E, Gallagher Rollin M

机构信息

University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Department of Psychiatry, Newark, NJ 07103, USA.

出版信息

Pain. 2006 Sep;124(1-2):117-25. doi: 10.1016/j.pain.2006.04.004. Epub 2006 May 15.

Abstract

Prior studies of careseeking fibromyalgia (FM) patients often report that they have an elevated risk of psychiatric disorders, but biased sampling may distort true risk. The current investigation utilizes state-of-the-art diagnostic procedures for both FM and psychiatric disorders to estimate prevalence rates of FM and the comorbidity of FM and specific psychiatric disorders in a diverse community sample of women. Participants were screened by telephone for FM and MDD, by randomly selecting telephone numbers from a list of households with women in the NY/NJ metropolitan area. Eligible women were invited to complete physical examinations for FM and clinician-administered psychiatric interviews. Data were weighted to adjust for sampling procedures and population demographics. The estimated overall prevalence of FM among women in the NY/NJ metropolitan area was 3.7% (95% CI=3.2, 4.4), with higher rates among racial minorities. Although risk of current MDD was nearly 3-fold higher in community women with than without FM, the groups had similar risk of lifetime MDD. Risk of lifetime anxiety disorders, particularly obsessive compulsive disorder and post-traumatic stress disorder, was approximately 5-fold higher among women with FM. Overall, this study found a community prevalence for FM among women that replicates prior North American studies, and revealed that FM may be even more prevalent among racial minority women. These community-based data also indicate that the relationship between MDD and FM may be more complicated than previously thought, and call for an increased focus on anxiety disorders in FM.

摘要

先前针对寻求治疗的纤维肌痛(FM)患者的研究经常报告称,他们患精神疾病的风险较高,但有偏差的抽样可能会扭曲真实风险。当前的调查采用了针对FM和精神疾病的最先进诊断程序,以估计在一个多样化的社区女性样本中FM的患病率以及FM与特定精神疾病的共病情况。通过电话从纽约/新泽西大都市地区有女性的家庭名单中随机选择电话号码,对参与者进行FM和重度抑郁症(MDD)的筛查。符合条件的女性被邀请完成FM的体格检查和临床医生进行的精神科访谈。对数据进行加权,以调整抽样程序和人口统计学特征。纽约/新泽西大都市地区女性中FM的估计总体患病率为3.7%(95%置信区间=3.2, 4.4),少数族裔中的患病率更高。虽然患有FM的社区女性当前患MDD的风险几乎是未患FM女性的3倍,但两组终生患MDD的风险相似。患有FM的女性终生患焦虑症的风险,尤其是强迫症和创伤后应激障碍,大约高出5倍。总体而言,这项研究发现女性中FM的社区患病率与先前北美研究结果一致,并表明FM在少数族裔女性中可能更为普遍。这些基于社区的数据还表明,MDD与FM之间的关系可能比之前认为的更为复杂,并呼吁更加关注FM中的焦虑症。

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