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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to determine the occurrence of psychological disturbances the authors studied 47 women who fulfilled the American College of Rheumatology Criteria for the classification of fibromyalgia and 25 random selected control patients without chronic muscle pain, all of whom live in Sorocaba, SP, Brazil. Personality disturbances were observable in 63.8% of the patients and 8.0% of the control group (p < 0.05); depression in 80.0% of the fibromyalgia group and 12.0% of the controls (p < 0.05) and anxiety in 63.8% of the patients and 16.0% of the controls (p < 0.05). The Hamilton test mean scores showed higher values for depression and anxiety among the fibromyalgia patients when compared to the control group. A significant association between fibromyalgia and depression, anxiety and personality disturbances was studied and recorded.
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PMID:Psychological aspects of Brazilian women with fibromyalgia. 759 74

A recent flurry of important studies has provided critical new information that is relevant to the contemporary understanding of the fibromyalgia syndrome. The concept that these patients represent solely a form of masked depression or a distinctive syndrome of somatization is not supported by the current facts. Rather it would appear that a characteristic peripheral nociceptive component is modulated by an interplay of complex central factors. A disruption of the neuroendocrine axis controlling growth hormone production may be the link between disturbed sleep and muscle pain, as growth hormone is produced predominantly during stage four sleep. A paradigm to link some of these newer findings is presented.
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PMID:Fibromyalgia and the facts. Sense or nonsense. 768 37

Given the lack of objective physical measures for assessing fibromyalgia syndrome (FS), the role of pain assessment is particularly important. The role of psychological factors is controversial among FS patients. This study was designed to better understand the relationship between pain behaviors and psychological variables. Specifically, this study (1) refined a pain behavior observation (PBO) methodology for use with FS patients, (2) determined whether stretching is a valid pain behavior, and (3) assessed whether psychological variables including self-efficacy and/or depression can predict pain behaviors after controlling for disease severity and age. The 73 FS subjects meeting the American College of Rheumatology classification system completed questionnaires measuring self-efficacy, depression, and pain. Trained physicians conducted tender-point examinations. Subjects were video-taped using a standardized procedure. Two trained raters independently coded all pain behaviors. Kappa coefficients and correlations among pain behaviors and self-reported pain indicated that the PBO method was both reliable and valid. However, the newly defined pain behavior 'stretching' was found to be negatively associated with self-reported pain. Hierarchical multiple regression (MR) analyses revealed that depression did not predict pain behavior over and above myalgic scores and age; however, in 3 separate MR analyses, self-efficacy for function, pain, and other symptoms each predicted pain behavior over and above myalgic scores and age. This study indicated that the original pain behavior scoring methodology is appropriate for use with the FS population and should not be modified to include the pain behavior 'stretching'. Self-efficacy was related to pain behavior while depression was not among this FS sample.
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PMID:Self-efficacy and pain behavior among subjects with fibromyalgia. 770 12

The article contains a discussion of conditions which may influence valuations of appeals to the Social Security Court from persons with the diagnosis fibromyalgia. An important question is to what extent economic depression and growing requirements for rights regarding grants from the Social Security System are of importance for the decisions. Of vital significance is the definition of disease in relation to Acts and regulations, especially the distinction between objective and subjective documentation of disease. The court's decisions function as guiding directives for the Social Insurance System in general. This implies that the Social Security Court can function as a social-political corrective.
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PMID:[The Social Security Court and verdicts on appeals from fibromyalgia patients. Central problems and dilemmas]. 785 17

The clinical and neurochemical association between depression and season noted in seasonal affective disorder (SAD) has suggested that clinical pain might also be linked to season, perhaps through similar neurochemistry or the known association of depression with pain. We investigated the pain-light season/dark season hypothesis in 2523 rheumatic disease outpatients by examining VAS Pain and VAS Global Severity scores, as well as levels of depression and functional disability. No clinically significant difference in pain severity between season (or individual month) was noted for the consecutive outpatients at their first clinic visit, nor in sub-analyses using paired light and dark season visits. A slight trend toward increased pain severity in lighter months by about 3% compared to darker months was identified. No effect of season was seen on depression scores. In a subset of patients with high depression scores, rheumatoid arthritis and osteoarthritis patients, respectively, reported 16% and 7% greater pain scores in light compared to dark months, but fibromyalgia patients had stable scores. Season does not appear to play an important role in pain and/or depression in rheumatic disorders.
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PMID:Effect of light and season on pain and depression in subjects with rheumatic disorders. 747 3

Thirty-six women with fibromyalgia (FM) were asked to describe how they live with their FM. Data were analysed using the constant comparative method. The goal was understanding the process of living with FM through theory development. The women described living with FM as struggling to maintain balance; this involves recalling perceived normality, searching for a diagnosis, finding out and moving on (transcending the illness). Several women relinquished the struggle because of situations that may or may not be under their control (e.g. depression and feeling imprisoned by treatment). Over time the illness moves from being a primary life focus to being part of the backdrop of the lives of women with FM.
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PMID:Struggling to maintain balance: a study of women living with fibromyalgia. 789 84

42 women were randomized to receive either placebo or fluoxetine at 20 mgs per day. Inter and intra group differences in clinical variables were evaluated after 3 and 6 weeks of treatment. Except for self rated anxiety which improved in the placebo treated group at 3 weeks, no differences between groups were noted. For those receiving fluoxetine both AIMS Anxiety (4.0 baseline vs. 3.3, p = 0.04) and Depression scores (2.6 baseline vs. 1.9, p = 0.03) improved at 3 weeks; however, improvement in the Beck Depression Scale did not reach significance (11.8 vs. 9.4, p = 0.34). At 6 weeks, both AIMS Depression (2.6 at baseline and 1.5 at 6 weeks, p = 0.03) and Beck Depression Scales (11.8 at baseline vs. 8.3 at 6 weeks, p = 0.04) showed improvement, as did sleep quality (9.6 vs. 7.6, p = 0.03). But no other variable had a significant change from baseline at either the 3 or 6 week point. Our data do not suggest that fluoxetine improves the signs and symptoms of fibromyalgia.
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PMID:A double-blind placebo controlled trial of fluoxetine in fibromyalgia. 797 79

This study reports psychological symptoms assessed in 327 patients with fibromyalgia (FS) in a multicenter investigation. Two self-report scales, in their validated Italian translations, were used for screening: the CES-D (the Center of Epidemiologic Studies-Depression) developed at the NIMH for measuring depression and the Illness Behavior Questionnaire (IBQ) developed by Pilowsky and Spence. The cutoff point of 23 in the CES-D scores revealed about 49% of the fibromyalgic patients as depressed. In analyzing patterns of illness behavior patients with FS showed a high score on IBQ scales of disease conviction, psychological versus somatic focusing and denial. CES-D scores showed significant correlations with illness behavior scales. These results and their implications for the treatment of fibromyalgic patients are discussed.
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PMID:Fibromyalgic syndrome: depression and abnormal illness behavior. Multicenter investigation. 806 55

The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. Fibromyalgia patients scored significantly higher than the controls on the Bech-Rafaelsen Melancholia Scale, the Atypical Depression Scale and the Hamilton Anxiety Rating Scale. On the Newcastle Depression Scale there was no difference. In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression.
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PMID:A blinded, controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia, as measured by standardized psychometric interview scales. 808 65

This study was designed to assess the reliability and validity of a Pain Behavior Observation method with fibromyalgia syndrome (FS) subjects and to determine the factors which predict pain behavior among FS subjects. Fifty-eight female FS subjects participated in the videotaped Pain Behavior Observation method. Subjects also completed the McGill Pain Questionnaire (MPQ), the Arthritis Impact Measurement Scale (AIMS), and the Symptoms Checklist-90-Revised (SCL-90-R). Pain behavior totals were derived using the Pain Behavior Observation method of McDaniel et al. (1986). Results indicated that the scoring method of Keefe and Block (1982) developed for use with back pain patients was more generalizable to this FS sample. Total pain behavior score using the Keefe and Block scoring method was correlated with self-report pain. Interrater reliability ranged from 0.9 to 0.99. Hierarchical multiple regression analyses revealed that age and physical disability predicted the total pain behaviors. The Pain Behavior Observation method appears a valid pain measurement technique independent of depression among FS patients. Directions for future research are discussed.
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PMID:Pain behavior predictors among fibromyalgia patients. 812 95


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