Majority of patients with fibromyalgia have at least one form of psychiatric disorder, while some have more than one, according to a study of female patients with fibromyalgia published in the journal Nursing Open.¹

To investigate the presence of psychiatric disorders in fibromyalgia, researchers recruited 159 women, aged 42 years (mean), with newly diagnosed fibromyalgia attending a rheumatology clinic between 2018 and 2019 in a cross-sectional study. Sleep quality was assessed with the aid of the Pittsburgh Sleep Quality Index (PSQI) and psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Analysis of data revealed the presence of at least one psychiatric disorder in 92.4% (n=147) of women with fibromyalgia. Among the psychiatric disorders, the most common were sleep disorders (90.5%) followed by mood disorders (52.8%), personality disorders (40.2%) and anxiety disorders (~17%). Among the mood disorders, major depressive disorder (MDD) and persistent depressive disorder (PDD) were most prevalent. Among the personality disorders, the most frequent were Cluster-B personality disorders. Women with Cluster-B personality disorders had “a higher prevalence rate of somatic symptom disorders (SSDs) and an odds ratio (OR) of 2.7”. Personality disorders were more prevalent among women aged 30-39 years vs the 40–50-year age group. Single women with fibromyalgia were more likely to have OCD than women who were married.

Several patients were found to have more than one psychiatric disorder. Thirty-two (20.1%) patients had coexisting mood disorders and sleep disorders; 25 patients (15.7%) had concurrent personality disorders, mood disorders and sleep disorders, while 28 patients (17.6%) had one type of Cluster-B personality disorder, mood disorder and a somatic symptom disorder.

This study highlights the high frequency of diverse psychiatric disorders in women with fibromyalgia, which “could exacerbate one another in a vicious cycle”, note the authors. Fibromyalgia requires multidisciplinary care. Management entails thorough assessment for psychiatric disorders.

Reference

1. Sadr S, et al. The frequency of psychiatric disorder co-morbidities in patients with fibromyalgia: A cross-sectional study in Iran. Nurs Open. 2023 Mar 22. doi: 10.1002/nop2.1731.