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与男性相比,重度抑郁症女性中的纤维肌痛情况。

Fibromyalgia among major depression disorder females compared to males.

作者信息

Vishne Tali, Fostick Lea, Silberman Alicia, Kupchick Marina, Rubinow Alan, Amital Haward, Amital Daniela

机构信息

Department of Psychiatry B, Ness-Ziona Mental Health Center, Ness-Ziona, Israel.

出版信息

Rheumatol Int. 2008 Jul;28(9):831-6. doi: 10.1007/s00296-008-0533-8. Epub 2008 Feb 2.

Abstract

The Fibromyalgia syndrome (FMS) is characterized by widespread pain and diffuse tenderness in specified locations. The literature clearly points out that FMS is more prevalent in females rather than males, and among patients with major depression disorder (MDD). The aim of the current study was to obtain a better conception of the linkage existing between depression, gender and FMS. Forty-two male patients and 42 age-matched females, as well as age-matched male and female healthy controls were evaluated for coexisting FMS using the American College of Rheumatology (ACR) classification criteria. Each patient completed a questionnaire characterizing the quality of their sleep, a Sheehan disability scale (SDS) and SF-36 scale to measure the quality of life. The degree of depression of each patient was scored using Hamilton depression rating scales (HDRS) and Global assessment was done using the Clinical Global Impression-Severity (CGI-S). Disease parameters were worse for men as compared to women; CGI-S: 5.4 +/- 1 (mean +/- standard deviation), versus 4.0 +/- 1 (t = 6.634, P < 0.001), HDRS: 23.9 +/- 6 versus 20.8 +/- 6 (t = 2.304, P = 0.024), respectively. Yet, FMS was more prevalent among depressed females; 26% versus 2%, (chi2(3) = 9.722, P = 0.002) and so were the average number of tender points (TP) (6.1 +/- 5 versus 2.2 +/- 3, t = 4.399, P < 0.001). The SF-36, SDS and sleep quality scores were similar between males and females. A one-way analysis of variance with gender and disease (depressed vs. non-depressed) revealed that both gender and disease were found to be significant contributing factors for the number of TP (F = 21.131, P < 0.0001; F = 65.232, P < 0.0001, respectively). A one-way analysis of covariance for TP with CGI-S and HDRS as covariates revealed that gender was a significant factor regardless of depression severity (F = 30.028, P < 0.001). CGI-S and Hamilton scores correlated with TP count in females (r = 0.396, P = 0.009, r = 0.531, P < 0.001) but not in males. Female gender is a risk factor for FMS in depressed population. Depression is associated with FMS among women but not among men. Among females, depression severity is significantly correlated to FMS severity. FMS is correlated to sleep quality and to quality of life among depressed patients.

摘要

纤维肌痛综合征(FMS)的特征是全身广泛疼痛以及特定部位的弥漫性压痛。文献明确指出,FMS在女性中比男性更普遍,且在重度抑郁症(MDD)患者中更为常见。本研究的目的是更好地理解抑郁症、性别与FMS之间存在的联系。使用美国风湿病学会(ACR)分类标准,对42名男性患者、42名年龄匹配的女性患者以及年龄匹配的男性和女性健康对照者进行了共存FMS的评估。每位患者都完成了一份描述其睡眠质量的问卷、一份希恩残疾量表(SDS)和用于测量生活质量的SF - 36量表。使用汉密尔顿抑郁评定量表(HDRS)对每位患者的抑郁程度进行评分,并使用临床总体印象 - 严重程度(CGI - S)进行总体评估。与女性相比,男性的疾病参数更差;CGI - S分别为5.4±1(平均值±标准差)和4.0±1(t = 6.634,P < 0.001),HDRS分别为23.9±6和20.8±6(t = 2.304,P = 0.024)。然而,FMS在抑郁女性中更为普遍;分别为26%和2%(χ2(3)=9.722,P = 0.002),压痛点数(TP)的平均数也是如此(6.1±5和2.2±3,t = 4.399,P < 0.001)。男性和女性之间SF - 36、SDS和睡眠质量得分相似。对性别和疾病(抑郁与非抑郁)进行的单因素方差分析显示,性别和疾病都是TP数量的重要影响因素(F分别为21.131,P < 0.0001;F为65.232,P < 0.0001)。以CGI - S和HDRS作为协变量对TP进行的单因素协方差分析显示,无论抑郁严重程度如何,性别都是一个重要因素(F = 30.028,P < 0.001)。CGI - S和汉密尔顿评分与女性的TP计数相关(r = 0.396,P = 0.009,r = 0.531,P < 0.001),但与男性无关。在抑郁人群中,女性性别是FMS的一个危险因素。抑郁症与女性的FMS相关,但与男性无关。在女性中,抑郁严重程度与FMS严重程度显著相关。FMS与抑郁患者的睡眠质量和生活质量相关。

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