Alciati Alessandra, Atzeni Fabiola, Caldirola Daniela, Perna Giampaolo, Sarzi-Puttini Piercarlo
Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, via Roma 16, 22032 Como, Italy.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve, Emanuele-Milan, Italy.
J Clin Med. 2020 Nov 10;9(11):3619. doi: 10.3390/jcm9113619.
About half of the patients with fibromyalgia (FM) had a lifetime major depression episode and one third had a panic disorder (PD). Because the co-morbidity between bipolar disorder (BD) and PD marks a specific subtype of BD we aimed to investigate if co-morbid BD/PD (comBD/PD) occurs more frequently than the single disorder in FM patients and evaluate the clinical significance and timing of this co-morbidity. Further, we explored the role of co-morbid subthreshold BD and PD. In 118 patients with FM, lifetime threshold and sub-threshold mood disorders and PD were diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) Clinical Interview. Demographic and clinical variables were compared in co-morbid BD/PD (comBD/PD) and not co-morbid BD/PD (nocomBD/PD) subgroups. The co-morbidity BD/PD was seen in 46.6% of FM patients and in 68.6% when patients with minor bipolar (MinBD) and sub-threshold panic were included. These rates are higher than those of the general population and BD outpatients. There were no statistically significant differences between threshold and sub-threshold comBD/PD and nocom-BD/PD subgroups in demographic and clinical parameters. In the majority of patients (78.2%), the onset of comBD/PD preceded or was contemporary with FM. These findings support the hypothesis that comBD/PD is related to the development of FM in a subgroup of patients.
约半数纤维肌痛（FM）患者有过终生重度抑郁发作，三分之一有惊恐障碍（PD）。由于双相情感障碍（BD）与PD共病是BD的一种特殊亚型，我们旨在研究在FM患者中，BD/PD共病（comBD/PD）是否比单一疾病更常见，并评估这种共病的临床意义和发生时间。此外，我们还探讨了亚阈值BD和PD共病的作用。对118例FM患者，采用《精神障碍诊断与统计手册》第四版修订本（DSM-IV-TR）临床访谈来诊断终生阈值和亚阈值心境障碍及PD。比较共病BD/PD（comBD/PD）和非共病BD/PD（nocomBD/PD）亚组的人口统计学和临床变量。46.6%的FM患者存在BD/PD共病，若纳入轻度双相（MinBD）和亚阈值惊恐患者，则该比例为68.6%。这些比率高于普通人群和BD门诊患者。阈值和亚阈值comBD/PD与nocom-BD/PD亚组在人口统计学和临床参数方面无统计学显著差异。在大多数患者（78.2%）中，comBD/PD的发作先于FM或与FM同时出现。这些发现支持了以下假设，即comBD/PD在一部分患者中与FM的发生有关。
