Alciati A, Sgiarovello P, Atzeni F, Sarzi-Puttini P
Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy.
Reumatismo. 2012 Sep 28;64(4):268-74. doi: 10.4081/reumatismo.2012.268.
To review the literature addressing the relationship between mood disorders and fibromyalgia/chronic pain and our current understanding of overlapping pathophysiological processes and pain and depression circuitry.
We selectively reviewed articles on the co-occurrence of mood disorders and fibromyalgia/chronic pain published between 1990 and July 2012 in PubMed. Bibliographies and cross references were considered and included when appropriate.
Forty-nine out of 138 publications were retained for review. The vast majority of the studies found an association between depression and fibromyalgia. There is evidence that depression is often accompanied by symptoms of opposite polarity characterised by heights of mood, thinking and behaviour that have a considerable impact on pharmacological treatment. Recent developments support the view that the high rates of fibromyalgia and mood disorder comorbidity is generated by largely overlapping pathophysiological processes in the brain, that provide a neurobiological basis for the bidirectional, mutually exacerbating and disabling relationship between pain and depression.
The finding of comparable pathophysiological characteristics of pain and depression provides a framework for understanding the relationship between the two conditions and sheds some light on neurobiological and therapeutic aspects.
回顾关于情绪障碍与纤维肌痛/慢性疼痛之间关系的文献，以及我们目前对重叠的病理生理过程、疼痛和抑郁神经回路的理解。
我们在PubMed上选择性地回顾了1990年至2012年7月间发表的关于情绪障碍与纤维肌痛/慢性疼痛共病的文章。适当考虑并纳入了参考文献和交叉引用。
138篇出版物中有49篇被保留用于综述。绝大多数研究发现抑郁与纤维肌痛之间存在关联。有证据表明，抑郁常伴有极性相反的症状，其特征为情绪、思维和行为的高涨，这对药物治疗有相当大的影响。最近的研究进展支持这样一种观点，即纤维肌痛和情绪障碍的高共病率是由大脑中大量重叠的病理生理过程产生的，这为疼痛和抑郁之间双向、相互加剧且使人衰弱的关系提供了神经生物学基础。
疼痛和抑郁具有可比的病理生理特征这一发现，为理解这两种情况之间的关系提供了一个框架，并在神经生物学和治疗方面有所启示。
