Posted by MERM on 6/21/2008, 11:08 am
1. role of generalized pain and pain behavior in tender point scores in fibromyalgia.
California School of Professional Psychology, Department of Psychiatry, University of California, San Diego, USA.
OBJECTIVE: To determine and assess the significance of the independent role of pain, pain behavior, depression, and weekly stress in tender point scores in objectively diagnosed fibromyalgia (FM) patients.
METHODS: One hundred eleven patients with FM recruited from the community and private and university based clinics participated in a comprehensive evaluation of their pain, psychological distress, and pain behavior. Tender point assessment was carried out across 18 discrete sites according to American College of Rheumatology criteria. Pain was assessed with a composite index of 4 pain measures; psychological distress consisted of measures of stress and depression, and pain behavior was measured by an objective index derived from a 10 minute videotaped sequence in which 5 pain behaviors were recorded.
RESULTS: Multiple regression analyses revealed that high pain, high pain behavior, and shorter illness duration were related independently to tender point scores. Measures of depression and weekly stress were not independently related to tender point scores.
CONCLUSION: Tender point scores are related to generalized pain and pain behavior tendencies in patients with FM, and do not independently reflect generalized psychological distress.
2/Chronic widespread musculoskeletal pain with or without fibromyalgia:
OBJECTIVE: To estimate the severity of depression, anxiety, and other symptoms of psychological distress in a representative general population sample of fibromyalgia (FM) cases (FC) compared to pain controls (PC), and to identify strong correlates of depression and anxiety.
METHODS: We compared the severity of depression, anxiety, and other symptoms of psychological distress between 2 representative community samples:
(1) 74 confirmed FC, and
(2) 48 adults with chronic widespread pain (PC) who did not meet the 1990 ACR criteria for FM. Psychological distress was measured using the Centre for Epidemiological Studies Depression (CES-D) Scale, the State-Trait Anxiety Inventory (STAI), and other measures of psychological distress from the literature. Using cutoff scores for CES-D and trait anxiety, we compared demographic and clinical characteristics in those above and below each cutoff score.
Simple linear regression was performed to identify factors strongly and independently correlated with depression and trait anxiety.
RESULTS: Compared to PC, FC were more symptomatic on virtually all measures of psychological distress. Similarly, individuals who scored above cutoff scores for depression and anxiety had more physical symptoms and had poorer function than those below.
Depression and trait anxiety were highly correlated (r = 0.86). In a simple regression model, the best predictors for both depression and trait anxiety were the total number of symptoms and a physical disability score.
CONCLUSION: Depression and anxiety are common and frequently severe even among community cases of FM.J Rheumatol. 2002 Mar;29(3):588-94.White KP, Nielson WR, Harth M, Ostbye T, Speechley M. wellnesstrain@M@
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