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纤维肌痛综合征中的精神共病与童年创伤

Psychiatric comorbidity and childhood trauma in fibromyalgia syndrome.

作者信息

Gündüz Nermin, Polat Aslıhan, Erzincan Erkal, Turan Hatice, Sade Ilgın, Tural Ümit

机构信息

Department of Psychiatry, Dumlupınar University School of Medicine Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey.

Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey.

出版信息

Turk J Phys Med Rehabil. 2018 Feb 25;64(2):91-99. doi: 10.5606/tftrd.2018.1470. eCollection 2018 Jun.

Abstract

OBJECTIVES

In this study, we aimed to compare patients with fibromyalgia syndrome (FMS) and those with myofascial pain syndrome (MPS) and healthy women and to investigate the prevalence of childhood traumatic experiences (CTEs) in relation to comorbid mood and anxiety disorders.

PATIENTS AND METHODS

Between February 2014 and May 2014, a total of 136 women including 52 with FMS, 35 with MPS, and 49 healthy controls were included in the study. The Sociodemographic Data Form, Mood and Anxiety Disorders Modules of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) Axis I Disorders (SCID-I), Fibromyalgia- related Symptom Scale (FSS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Childhood Trauma Questionnaire-28 (CTQ-28) were applied to participants.

RESULTS

As a result of the semi-structured clinical interview conducted by a psychiatrist experienced in psychological trauma, the prevalence of any mood or anxiety disorder were found to be significantly more common in the FMS group. Childhood traumatic experiences, not only in general, but also with all subtypes, were also reported to be significantly more in FMS patients. Besides, only in patients with FMS, a significant relationship was found between the psychiatric diagnoses and the presence of CTEs. Furthermore, the CTQ-28 scores were correlated positively with the FSS scores as well as HDRS and HARS. Among the symptoms screened by the FSS, only crying and over-reacting to incidents were significantly associated with CTEs in FMS group.

CONCLUSION

Based on our study results, CTEs may play a critical role in the development of fibromyalgia and may be related with comorbid mood and anxiety disorders in FMS patients. Associating psychological symptoms such as crying or over-reacting to incidents in FMS patients should be, therefore, alerting for psychiatric consultation.

摘要

目的

在本研究中,我们旨在比较纤维肌痛综合征(FMS)患者、肌筋膜疼痛综合征(MPS)患者和健康女性,并调查童年创伤经历(CTE)与共病情绪和焦虑障碍的患病率。

患者与方法

2014年2月至2014年5月,共有136名女性纳入研究,其中52名FMS患者、35名MPS患者和49名健康对照。对参与者应用社会人口学数据表、《精神疾病诊断与统计手册》第四版(DSM-IV)轴I障碍的结构化临床访谈的情绪和焦虑障碍模块(SCID-I)、纤维肌痛相关症状量表(FSS)、汉密尔顿抑郁评定量表(HDRS)、汉密尔顿焦虑评定量表(HARS)和儿童创伤问卷-28(CTQ-28)。

结果

由一位在心理创伤方面经验丰富的精神科医生进行的半结构化临床访谈结果显示,任何情绪或焦虑障碍的患病率在FMS组中显著更高。据报告,童年创伤经历不仅总体上,而且在所有亚型中,在FMS患者中也显著更多。此外,仅在FMS患者中,发现精神科诊断与CTE的存在之间存在显著关系。此外,CTQ-28评分与FSS评分以及HDRS和HARS呈正相关。在FSS筛查的症状中,仅哭泣和对事件过度反应在FMS组中与CTE显著相关。

结论

基于我们的研究结果,CTE可能在纤维肌痛的发展中起关键作用,并且可能与FMS患者的共病情绪和焦虑障碍有关。因此,FMS患者中诸如哭泣或对事件过度反应等心理症状应提醒进行精神科咨询。

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