Fibromyalgia: Life Events Prior To Onset And Axis I Comorbidity

ObjectiveThe 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 fibromyalgia, and secondly, to investigate the relationship between these variables and pain and disability due to fibromyalgia.MethodLife events were investigated through the administration of Paykel's Scale for Recent Life Events, and Axis I comorbidities by means of the Structured Clinical Interview for DSM-IV Axis I Disorders in a group of subjects diagnosed with fibromyalgia according to the American 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 Fibromyalgia Impact Questionnaire scores, on one hand, and life events and Axis I comorbidities, on the other, were examined by means of independent sample t-tests and Pearson correlations.ResultsFourty patients were included in the present study. Life events prior to fibromyalgia onset occurred in 67.5% of the subjects (35% of patients had a severe life events prior to onset) (Table I). Axis I comorbid disorders were common among patients, with 67.5% and 57.5% of them satisfying of the Structured Clinical Interview for DSM-IV Axis I Disorders criteria for a lifetime and current mental disorder, respectively (Table IV). Mood and Anxiety Disorders were the most frequently encountered disorders. A higher Fibromyalgia 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.ConclusionsThe onset of fibromyalgia is often preceded 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 presenting with fibromyalgia.