纤维肌痛与精神障碍。
Fibromyalgia and psychiatric disorders.
作者信息
Fietta Pierluigi, Fietta Pieranna, Manganelli Paolo
机构信息
Department of Psychiatry, Hospital of Lodi, Lodi, Italy.
出版信息
Acta Biomed. 2007 Aug;78(2):88-95.
Fibromyalgia (FM) is a common and polymorphic syndrome, characterized by long-lasting, widespread musculoskeletal pain, in the presence of 11 or more tender points located at specific anatomical sites. A heterogeneous series of disturbances, mainly involving autonomic, neuroendocrine and neuropsychic systems, is usually present. Even if subjective, the chronic psychophysical suffering state of FM adversely affects the patient's quality of life, performance and mood. Cognitive behavioural therapy and antidepressant drugs are useful in FM treatment, suggesting a close link between the syndrome and psychiatric, psychological and behavioural factors. Our aim was to evaluate the personality profiles of FM patients, as well as the aggregation and relationships between FM and psychiatric disorders (PD), reviewing the available evidences in current literature on this comorbidity. Personality variables associated with psychological vulnerability are frequent in FM patients. Personality disorders are rarely reported. Compared with controls, FM patients show a significantly higher prevalence of depressive and anxiety disorders, reported in 20-80% and 13-63.8% of cases, respectively. This high variability may depend on the psychosocial characteristics of patients, since most of the studies were performed on tertiary care consulting patients, however, even referring to the lower percentages, the occurrence of PD is significantly higher in FM subjects compared to the general population (7%). Moreover, elevated frequencies of PD have been detected in relatives of FM patients. The FM/PD aggregation suggests a common physiopathology, and alterations of neurotransmitter systems may constitute the shared underlying factor.
纤维肌痛(FM)是一种常见的多态性综合征,其特征为持久的广泛性肌肉骨骼疼痛,且在特定解剖部位存在11个或更多的压痛点。通常还存在一系列异质性紊乱,主要涉及自主神经系统、神经内分泌系统和神经精神系统。尽管FM的慢性心理生理痛苦状态是主观的,但它会对患者的生活质量、表现和情绪产生不利影响。认知行为疗法和抗抑郁药物对FM治疗有效,这表明该综合征与精神、心理和行为因素之间存在密切联系。我们的目的是评估FM患者的人格特征,以及FM与精神障碍(PD)之间的聚集情况和关系,回顾当前文献中关于这种共病的现有证据。与心理易感性相关的人格变量在FM患者中很常见。人格障碍的报告较少。与对照组相比,FM患者中抑郁和焦虑障碍的患病率显著更高,分别在20% - 80%和13% - 63.8%的病例中报告。这种高变异性可能取决于患者的社会心理特征,因为大多数研究是在三级医疗咨询患者中进行的,然而,即使参考较低的百分比,FM患者中PD的发生率也明显高于一般人群(7%)。此外,在FM患者的亲属中也检测到PD的频率升高。FM/PD的聚集表明存在共同的病理生理学,神经递质系统的改变可能构成共同的潜在因素。