Lizama-Lefno Andrea, Mojica Krystel, Roco-Videla Ángel, Ruiz-Tagle Juan Ignacio Vargas, González-Droguett Nelia, Muñoz-Yánez María Jesús, Atenas-Núñez Erick, Maureira-Carsalade Nelson, Flores Carrasco Sergio
Dirección de Desarrollo y Postgrados, Universidad Autónoma de Chile, Galvarino Gallardo 1983, Santiago 7500138, Chile.
Fundación Núcleo de Investigación DOLMEN, El Director 6000, Of. 207, Las Condes, Santiago 7580023, Chile.
Biomedicines. 2024 Oct 9;12(10):2284. doi: 10.3390/biomedicines12102284.
BACKGROUND/OBJECTIVES: Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and mental health issues. It affects approximately 1.78% of the general population; an estimated 4:1 ratio between women and men is observed. It significantly impacts quality of life and carries both clinical and social stigma. This study aims to evaluate the relationship between drug use and mental health in female patients with fibromyalgia.
This study is prospective, observational, and cross-sectional. A questionnaire was administered to 544 subjects, achieving a representative sample size from a population of 800,000 subjects by using an algorithm for proportion estimation with a known sampling frame. The selection was non-random, making the sampling non-probabilistic. Logistic regression models were applied to assess the effect of drug use on perception of mental health; presence of symptoms such as comprehension and memory problems, insomnia, depression, and anxiety; and severity of cognitive symptoms and non-restorative sleep. To quantify the impact, odds ratios and confidence intervals have been observed.
The findings indicate the non-recommended use of medications and reveal the ineffectiveness and adverse effects of drug interactions on mental health. The use of benzodiazepines and sedative-hypnotics is significantly associated with a negative perception of mental health. Benzodiazepines do not improve symptoms or significantly reduce their severity. SSRI antidepressants do not enhance mental health perception; however, when used exclusively, they are effective in reducing the severity, but not the prevalence, of cognitive symptoms.
The results highlight the complexity of pharmacological management in FM and raise concerns about the inappropriate use of ineffective or counterproductive drug interactions affecting patients' mental health. They underscore the need for multidisciplinary and personalized strategies that include close and careful monitoring, as well as the simultaneous use of non-pharmacological treatments that have demonstrated evidence in improving quality of life without negatively affecting mental health, such as patient education, psychological therapy, physiotherapy, and mindfulness.
背景/目的：纤维肌痛（FM）是一种慢性综合征，其特征为广泛的肌肉骨骼疼痛、疲劳、睡眠障碍和心理健康问题。它影响着约1.78%的普通人群；男女比例约为4:1。它对生活质量有显著影响，且存在临床和社会污名。本研究旨在评估纤维肌痛女性患者药物使用与心理健康之间的关系。
本研究为前瞻性、观察性和横断面研究。通过使用已知抽样框架的比例估计算法，对544名受试者进行了问卷调查，从80万受试者群体中获得了具有代表性的样本量。选择是非随机的，使得抽样为非概率性。应用逻辑回归模型来评估药物使用对心理健康认知的影响；诸如理解和记忆问题、失眠、抑郁和焦虑等症状的存在；以及认知症状和非恢复性睡眠的严重程度。为了量化影响，观察了比值比和置信区间。
研究结果表明存在不推荐的药物使用情况，并揭示了药物相互作用对心理健康的无效性和不良影响。苯二氮䓬类药物和镇静催眠药的使用与对心理健康的负面认知显著相关。苯二氮䓬类药物不能改善症状或显著减轻其严重程度。选择性5-羟色胺再摄取抑制剂（SSRI）类抗抑郁药不能增强心理健康认知；然而，单独使用时，它们在减轻认知症状的严重程度方面有效，但对其患病率无效。
结果突出了纤维肌痛药物治疗管理的复杂性，并引发了对影响患者心理健康的无效或适得其反的药物相互作用不当使用的担忧。它们强调了多学科和个性化策略的必要性，这些策略包括密切和仔细的监测，以及同时使用在改善生活质量而不负面影响心理健康方面已证明有证据的非药物治疗方法，如患者教育、心理治疗、物理治疗和正念。
