Kravitz H M, Katz R S, Helmke N, Jeffriess H, Fawcett J
Department of Psychiatry (H.M.K., J.F., H.J.) and the Department of Internal Medicine, Section of Rheumatology (R.S.K., N.H.), Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
J Clin Rheumatol. 1995 Jun;1(3):165-70.
Previous research has suggested that some fibromyalgia may be part of an "affective spectrum disorder," pathophysiologically related to major depression. To examine the suspected association between fibromyalgia syndrome and depression, we conducted a family history study of depression among the first degree relatives (parents, siblings, and children) of two groups of probands with fibromyalgia, one with and one without a lifetime history of major depressive disorder. We tested the hypothesis that depression in patients with fibromyalgia is associated with a family history of depression. Major psychopathology in the probands was assessed with the Schedule for Affective Disorders and Schizophrenia and diagnosed using the Research Diagnostic Criteria. Forty fibromyalgia probands with and 14 fibromyalgia probands without a lifetime history of depression were interviewed about their parents, siblings, and children using the Family History Research Diagnostic Criteria format. Odds ratios were calculated, comparing the proportions of relatives with a history of depression in the two fibromyalgia proband groups. Lifetime histories of depression were found in 18% (n = 16) of the relatives of the probands with fibromyalgia and depression and in 9% (n = 25) of the relatives of the probands who did not have depression. Probands who had fibromyalgia and a history of major depression had more than twice the odds of having a relative who had depression than did the probands who had fibromyalgia but did not have a history of depression (odds ratio = 2.17 (95% confidence interval = 1.02-4.47)). These results suggest that depression in patients with fibromyalgia is associated with a family history of depression. Thus major depressive disorder in patients with fibromyalgia may be attributed more to their familial predisposition to depression than to a reaction to the pain and disability associated with fibromyalgia.
先前的研究表明，某些纤维肌痛可能是“情感谱系障碍”的一部分，在病理生理上与重度抑郁症相关。为了研究纤维肌痛综合征与抑郁症之间的疑似关联，我们对两组患有纤维肌痛的先证者的一级亲属（父母、兄弟姐妹和子女）进行了抑郁症家族史研究，其中一组有重度抑郁症的终生病史，另一组没有。我们检验了纤维肌痛患者的抑郁症与抑郁症家族史相关的假设。使用情感障碍和精神分裂症日程表对先证者的主要精神病理学进行评估，并根据研究诊断标准进行诊断。采用家族史研究诊断标准格式，对40名有抑郁症终生病史的纤维肌痛先证者和14名无抑郁症终生病史的纤维肌痛先证者就其父母、兄弟姐妹和子女进行了访谈。计算优势比，比较两个纤维肌痛先证者组中有抑郁症病史的亲属比例。在有纤维肌痛和抑郁症的先证者的亲属中，18%（n = 16）有抑郁症终生病史；在没有抑郁症的先证者的亲属中，这一比例为9%（n = 25）。有纤维肌痛且有重度抑郁症病史的先证者，其亲属有抑郁症的几率是有纤维肌痛但无抑郁症病史的先证者的两倍多（优势比 = 2.17（95%置信区间 = 1.02 - 4.47））。这些结果表明，纤维肌痛患者的抑郁症与抑郁症家族史相关。因此，纤维肌痛患者的重度抑郁症可能更多地归因于其家族性抑郁症易感性，而非对与纤维肌痛相关的疼痛和残疾的反应。
