Fibromyalgia Linked to Increased Depression Among Women

Credit: Unsplash / Arif Riyanto

Anxiety and depression following a fibromyalgia diagnosis is more common among women than men, according to findings from a new study.¹

In new data from a retrospective cohort analysis conducted by a team of Spanish investigators, a fibromyalgia diagnosis was associated with a two-fold increased likelihood of developing anxiety and/or depression than that of a control population. What’s more, the rheumatic, pain-centric condition was associated with a lower survival rate over an 8-year period when coupled with psychiatric burden.

Investigators led by Gloria Sauch Valmana, of the Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina in Barcelona, sought to analyze the associated risk between fibromyalgia and incidence of an anxiety and/or depression diagnosis among the general population of Catalonia from 2010-2017.

They noted that fibromyalgia has been frequently associated with fatigue and sleep disorders, as well as anxiety and depressive disorders.

“Some studies point to genetic predisposition, environmental triggers and neuromodulation being involved in the onset and course of the disease, while other studies point to the existence of predisposing factors being associated with a high rate of functional disability,” they wrote. “A literature review found that the symptoms experienced by men could not be identified in the same way as in women, so there could be an underdiagnosis of this disease in men, who manifest more sleep pattern disturbances and a poorer quality of life.”

Previous analyses have suggested the prevalence of depression and anxiety could be anywhere from 12% to 36% among patients with fibromyalgia, while the disease’s associated pain and other symptoms may even worsen that rate.

Valmana and colleagues conducted a retrospective analysis of patients from the databases of 283 primary care teams in the Catalan Health Institute representing 6.4 million persons ≥18 years old. Patient medical records included sociodemographic and pharmacological prescription information, as well as diagnoses and clinical measures for conditions.

Their analysis included 100,000-plus patients, of which 20,968 (20.7%) had fibromyalgia and 80,210 (79.3%) served as controls. All eligible patients were free of an anxiety or depression diagnosis at the 2010 baseline.

Between 2010 – 2017, one-third (32.3%) of patients with fibromyalgia developed anxiety and/or depression, versus just 14.5% of the population control (P <.05). Lone anxiety development was two-fold greater among patients; lone depression development was three-fold greater.

Investigators observed a 58% overall lower risk of developing anxiety and/or depression among the control population versus the fibromyalgia patient population. What’s more, males with fibromyalgia were 45% less likely to develop either burden than women patients (P <.05). They observed no differences based on age, however.

Survival rates among patients with fibromyalgia who were also diagnosed with anxiety and/or depression was 26.6% lower at 8 years versus control.

As the team noted in their discussion, fibromyalgia is more prevalent in women; despite this common fact, their time to diagnosis is generally 6 years, with comorbidities, patient age and a lack of physician experience playing integral roles in that time period being even worse at times. This reality, combined with the impact of psychiatric burden among female patients, heightens the need for more timely and comprehensive care.

“The trend toward the biopsychosocial model highlights the importance of psychopathology and early referral to mental health professionals to improve the quality of life of patients and guide the development of individualized multicomponent nonpharmacological therapies according to gender differences,” they wrote.

What’s more, Valmana and colleagues concluded their findings highlight the significance of public health strategies for fibromyalgia, including new policies and daily care strategies that address the complexities of disease.

References

1. ^{Sauch Valmaña G, Miró Catalina Q, Carrasco-Querol N, Vidal-Alaball J. Gender, Mental Health and Socioeconomic Differences in Fibromyalgia: A Retrospective Cohort Study Using Real-World Data from Catalonia. Healthcare (Basel). 2023;11(4):530. Published 2023 Feb 10. doi:10.3390/healthcare11040530}