La sindrome fibromialgica: eventi di vita correlati all’esordio e comorbidità di Asse I

Objective The aim of the study was first to examine life events occurred in the 12 months prior to onset and Axis I comorbidities in a group of subjects with fibromyal- gia, and secondly, to investigate the re- lationship between these variables and pain and disability due to fibromyalgia. Method Life events were investigated through the administration of Paykel’s Scale for Recent Life Events, and Axis I comorbid- ities by means of the Structured Clinical Interview for DSM-IV Axis I Disorders in a group of subjects diagnosed with fibromyalgia according to the Ameri- can College of Rheumatology criteria. The severity of pain and the degree of impairment due to fibromyalgia were investigated through a Visual Analogue Scale and the fibromyalgia Impact Questionnaire. Correlations between Visual Analogue Scale and Fibromyal- gia Impact Questionnaire scores, on one hand, and life events and Axis I co- morbidities, on the other, were exam- ined by means of independent sample t-tests and Pearson correlations. Results Fourty patients were included in thepresent study. Life events prior to fibro- myalgia onset occurred in 67.5% of the subjects (35% of patients had a severe life events prior to onset)(TableI). Axis I comorbid disorders were com- mon among patients, with 67.5% and 57.5% of them satisfying of the Struc- tured Clinical Interview for DSM-IV Axis I Disorders criteria for a lifetime and current mental disorder, respec- tively (Table IV). Mood and Anxiety Disorders were the most frequently encountered disorders. A higher Fibro- myalgia Impact Questionnaire score (higher disability) was related to higher Hamilton Rating Scale For Depression scores, having a current mood disorder and onset preceded by at least one life event (Table V). Subjects with anxiety disorder comorbidity had higher Visual Analogue Scale scores. Conclusions The onset of fibromyalgia is often pre- ceded by stressful life events, which also contribute to greater disability. Axis I comorbid disorders are frequent among fibromyalgia patients; both mood and anxiety disorders contribute to a higher degree of impairment. Our results confirm literature data and highlight the need of a careful psychiatric examination of patients present- ing with fibromyalgia