Alciati Alessandra, Atzeni Fabiola, Grassi Massimiliano, Caldirola Daniela, Riva Alice, Sarzi-Puttini Piercarlo, Perna Giampaolo
Department of Clinical Neurosciences, Villa San Benedetto Menni, Hermanas Hospitalarias, FoRiPsi, Albese con Cassano, Como, Italy.
IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
Clin Exp Rheumatol. 2017 May-Jun;35 Suppl 105(3):112-118. Epub 2017 Jun 29.
OBJECTIVES: Fibromyalgia (FM) is a syndrome of unknown aetiology that is frequently associated with depressive disorders, and childhood adversities (including maltreatment and parental loss) are frequently described in subjects with FM and depression. The aim of this study was to investigate the extent to which the high percentage of childhood adversities reported by patients with FM is related to FM itself or to a comorbid lifetime depressive disorder. METHODS: Ninety-four consecutive FM patients were assessed for lifetime major depression using the DSM-IVSCID-CV interview. Childhood maltreatment was investigated using the Childhood Trauma Questionnaire, and information relating to parental death or separation before the age of 18 years was collected by means of a semi-structured interview. The Zung Self-Rating Depression Scale, used as a quantitative measure of depressive symptoms, and the childhood adversity assessment were recorded at the same time. RESULTS: Sixty of the 94 FM patients (63.8%) were diagnosed as having a lifetime major depressive disorder. There were no significant associations between childhood parental loss, the presence/level of maltreatment, the occurrence of a lifetime major depression episode, and the Zung Self-Rating Depression Scale scores. CONCLUSIONS: The results of this study suggest that there is no association between childhood adversities and comorbid lifetime major depression in patients with FM. As it would be helpful to prevent the development of FM because of the high cost and limited efficacy of therapeutic interventions, childhood adversities may offer targets for primary prevention.
目的:纤维肌痛(FM)是一种病因不明的综合征,常与抑郁症相关,FM患者及抑郁症患者中常出现童年逆境(包括虐待和父母离世)。本研究旨在调查FM患者报告的高比例童年逆境在多大程度上与FM本身或终生共病抑郁症有关。 方法:采用DSM-IVSCID-CV访谈对94例连续性FM患者进行终生重度抑郁症评估。使用儿童创伤问卷调查童年虐待情况,并通过半结构化访谈收集18岁之前父母死亡或离异的相关信息。同时记录作为抑郁症状定量测量工具的zung自评抑郁量表以及童年逆境评估情况。 结果:94例FM患者中有60例(63.8%)被诊断为终生患有重度抑郁症。童年时期父母离世、虐待的存在/程度、终生重度抑郁发作的发生与zung自评抑郁量表得分之间均无显著关联。 结论:本研究结果表明,FM患者的童年逆境与终生共病重度抑郁症之间没有关联。鉴于治疗干预成本高且疗效有限,预防FM的发生将有所帮助,童年逆境可能为一级预防提供靶点。
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