Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Rheumatology Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Clin Exp Rheumatol. 2021 May-Jun;39 Suppl 130(3):33-38. doi: 10.55563/clinexprheumatol/j4nkzd. Epub 2020 Feb 26.
Literature shows high rates of comorbidity between fibromyalgia (FM) and mood disorders, especially major depressive disorder (MMD), reported in more than half of the cases. Consistently, patients with FM also present high rates of mood spectrum symptoms, despite scant data are still available on the relationship with antidepressant treatment outcomes. The present study was aimed at exploring the clinical outcome of patients with FM-MDD comorbidity naturalistically treated with antidepressant drugs, besides the relationships between mood spectrum symptoms and the treatment response.
A total sample of 40 patients with FM and MDD, who started a treatment with an antidepressant drug, was recruited at the Rheumatology Unit of the University of Pisa, Italy. Patients were evaluated at baseline and after 1 (T1) and 6 months (T2) of the treatment with an antidepressant drug. Assessments included: the Mood Spectrum-Self Report (MOODS-SR) for mood spectrum symptoms, the Short Form Health Survey (SF-36) for the global functioning and the Clinical Global Impression (CGI) for the clinical severity and improvement. All instruments were administered at baseline and the SF-36 and CGI were repeated at T1 and T2.
Twenty-eight (70%) patients reported an improvement at the CGI at T2. At T1 and T2 the CGI item-1 and most of the SF-36 domain scores significantly improved with respect to the T0, with the exception of the "role physical" and "role emotional" subscales. Improved patients reported higher scores in the energy depressive MOODS-SR domain. Furthermore, correlations emerged between several MOODS-SR domains and the CGI or SF-36 subscales scores at T0.
Our results corroborate previous findings on the role of antidepressant drugs in the management not only of MDD symptoms, but also of the painful component of FM. FM patients should be investigated for Mood Spectrum symptomatology considering its prominent role on the manifestations of the disorder and treatment outcome.
文献表明，纤维肌痛（FM）与心境障碍之间存在很高的共病率，尤其是在一半以上的病例中报告的重度抑郁症（MMD）。同样，尽管关于与抗抑郁治疗结果的关系仍缺乏数据，但 FM 患者也表现出很高的心境谱症状发生率。本研究旨在探讨自然接受抗抑郁药物治疗的 FM-MDD 共病患者的临床结局，以及心境谱症状与治疗反应之间的关系。
在意大利比萨大学风湿病科共招募了 40 名 FM 和 MDD 患者，他们开始使用抗抑郁药物治疗。在开始抗抑郁药物治疗时（T0）、治疗 1 个月时（T1）和 6 个月时（T2）对患者进行评估。评估包括：心境谱自报告量表（MOODS-SR）评估心境谱症状、健康调查简表（SF-36）评估整体功能以及临床总体印象量表（CGI）评估临床严重程度和改善程度。所有工具均在 T0 进行评估，SF-36 和 CGI 在 T1 和 T2 时重复评估。
28 名（70%）患者在 T2 时根据 CGI 报告改善。与 T0 相比，在 T1 和 T2 时，CGI 项目 1 和大多数 SF-36 领域的评分均显著改善，“躯体角色”和“情感角色”两个子量表除外。改善的患者报告说，MOODS-SR 能量抑郁域的评分更高。此外，在 T0 时，MOODS-SR 域与 CGI 或 SF-36 子量表评分之间出现了相关性。
我们的结果证实了之前关于抗抑郁药物在管理 MDD 症状以及 FM 疼痛成分中的作用的研究结果。FM 患者应进行心境谱症状检查，因为其在疾病表现和治疗结果中具有突出作用。
