Fibromyalgia Severity Linked to Depressive and Bipolar Symptoms

Although a seemingly invisible condition, fibromyalgia (FM) may have an important connection with mental health symptoms.

FM has the power to heavily impact patients both physically and mentally. One study even went as far as determining that patients with fibromyalgia have a poorer quality of life than those with chronic pain. While psychological factors have previously been linked with the severity of pain, researchers from the Cleveland Clinic further evaluated the relationship between discomfort and mental health symptoms.

“Reported rates of depressive symptoms in FM vary between 9.2% and 90%, depending on the screening or diagnostic method used,” the authors wrote in the International Journal of Rheumatic Diseases.

With such a large range, this study aimed to identify the prevalence of depressive and bipolar symptoms in patients with FM. A total of 305 patients with FM — average age of 43.53 and 82.7% female – completed the Patient Health Questionnaire (PHQ-9) and Mood Disorders Questionnaire (MDQ). The results showed:

• No depression: 11.4%
• Mild: 29.1%
• Moderate: 27.5%
• Moderate severe: 17.7%
• Severe: 14%

In addition, 41.6% of the participants had anxiety and 21.3% had a history of bipolar disorder (BD) and/or reached a MDQ score of at least 7. The report informed that 59.7% of patients had a PHQ-9 score of at least 10 with the average being 11.9.

The findings indicated that increased levels of depression or BD were connected with more severe FM symptoms and duration of morning stiffness. It was noted that depression was associated with history of sexual abuse and lower socioeconomic status.

“Patients with severe FM disease activity, high load of symptoms, prolonged morning stiffness, increased disability, lower socioeconomic status and those who take a lot of medications for FM should be evaluated for depressive and manic symptoms,” the researchers concluded.