Mental Health Status in Patients with Fibromyalgia


 Fibromyalgia, Depression, Anxiety, Psychological Disorders, Mental Health.

How to Cite

Sousan Kolahi, Ali Fakhari, Mehrzad Hajaliloo, Alireza Khabbazi, Sahar Hassanzadeh Dizaj, & Mahdi Hemati. (2014). Mental Health Status in Patients with Fibromyalgia. Journal of Basic & Applied Sciences, 10, 509–513.


Background: It has long been shown that chronic conditions are usually accompanied by psychosocial disorders. Fibromyalgia (FM) is not an exception in this regard. The aim of this study is to evaluate the mental health in FM patients.
Methods: In an analytic-descriptive setting, patients with diagnosis of FM were inquired according to general health questionnaire-28 (GHQ-28) and severity of pain was inquired based on visual analogue scale (VAS). Somatic symptoms, anxiety/insomnia, social dysfunction and severe depression were assessed.
Results: One hundred female patients with mean age of 44.66±11.34 years were enrolled. According to GHQ-28, 55% of the patients with FM have suffered from psychological abnormalities.The prevalence of suspected psychological disorders, were 68 % in ""somatic symptoms"", 18% in “depression” and ""anxiety and insomnia"" and 53% in ""social dysfunction"". There were a significant positive correlation between VAS and level of somatic symptoms, social dysfunction and severe depression.
Conclusion: This study showed that a considerable portion of patients with FM may suffer concurrently from psychological disorders. The probability of these diseases increases with the severity of pain, hence effective pain reducing policies may be useful in providing a better quality of life.


Şengül CB, Ateş A, Şengül C, Okay T, Dilbaz N, Karaaslan Y, et al. Fibromiyalji ve Romatoid Artritli Hastalarda Anksiyete, Depresyon, Aleksitimi ve Disosiyasyon Seviyeleri ve Bu Parametrelerin. Türkiye'de Psikiyatri 2006; 10: 104-108.

Santos AMB, Assmpcao A, Matsutani LA, Pereira CAB, Lage LV. Depressão e qualidade de vida em pacientes com Fibromialgia. Revista Brasileira de Fisioterapia 2005; 10: 317-324.

Goldenberg DL. Fibromyalgia syndrome. An emerging but controversial condition. JAMA 1987; 257: 2782-7.

Raphael KG, Janal MN, Nayak S, Schwartz JE, Gallagher RM. Psychiatric comorbidities in a community sample of women with fibromyalgia. Pain 2006; 124: 117-125.

Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995; 38: 19-28.

Robinson RL, Birnbaum HG, Morley MA, Sisitsky T, Greenberg PE, Wolfe F. Depression and fibromyalgia: treatment and cost when diagnosed separately or concurrently. J Rheumatol 2004; 31: 1621-30.

Epstein SA, Williams DA, Osbeck L. Effect of psychological factors on pain perception in fibromyalgia. Psychosomatics 1995; 36, 192.

Ahles TA, Khan SA, Yunus MB, Spiegel DA, Masi AT. Psychiatric status of patients with primary fibromyalgia, patients with rheumatoid arthritis, and subjects without pain: a blind comparison of DSM-III diagnoses. Am J Psychiatry 1991; 148: 1721-6.

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33: 160-17.

Farsi Z, Jabari Morouei M, Ebadi A. General health assessment of Army soldiers seen in a military medical outpatient clinic in Tehran. Journal of Army University of Medical Sciences of the Iran 2006; 3: 923-30.

Ebrahimi A, Molavi H, Moosavi G, Bornamanesh A, Yaghobi M. Psychometric Properties and Factor Structure of General Health Questionnaire 28 (GHQ-28) in Iranian Psychiatric Patients. Journal of Research in Behavioural Sciences 2007; 1: 5-12.

Walker EA, Keegan D, Gardner G, Sullivan M, Katon WJ, Bernstein D. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: I. Psychiatric diagnoses and functional disability. Psychosom Med 1997; 59: 565-71.

Goldenberg DL. Psychologic studies in fibrositis. Am J Med 1986; 81(Suppl. 3A): 67-70.

Thieme K, Turk DC, Flor H. Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables. Psychosom Med 2004; 66: 837-40.

Lesley M A, James I H, Evelyn V H, Avis E W, Deborah A F, Megan BA et al. Family Study of Fibromyalgia. Arthritis & Rheumatism 2004; 50: 944-52.

Toussaint LL, Vincent A, McAllister SJ, Oh TH, Hassett AL. Comparison of Fibromyalgia Symptoms in Patients with Healthy versus Depressive, Low and Reactive Affect Balance Styles. Scand J Pain 2014; 1: 161-6.

Benjamin S, Morris S, McBeth J, Macfarlane GJ, Silman AJ. The association between chronic widespread pain and mental disorder: a population-based study. Arthritis Rheum 2000; 43: 561-7.<561::AID-ANR12>3.0.CO;2-O

Felson DT. Comparing the prevalence of rheumatic diseases in China with the rest of the world. Arthritis Res Ther 2008; 10: 106.

White KP, Nielson WR, Harth M, Ostbye T, Speechley M. Chronic widespread musculoskeletal pain with or without fibromyalgia: psychological distress in a representative community adult sample. J Rheumato 2002; 29: 588-94.

Malt EA, Berle JE, Olafsson S, Lund A, Ursin H. Fibromyalgia is associated with panic disorder and functional dyspepsia with mood disorders. A study of women with random sample population controls. J Psychosom Res 2000; 49: 285-9.

Schwartzbaum J, Ahlbom A, Feychting M. Berkson's bias reviewed. Eur J Epidemiol 2003; 18: 1109-12.

Galbaud du Fort G, Newman SC, Bland RC. Psychiatric comorbidity and treatment seeking. Sources of selection bias in the study of clinical populations. J Nerv Ment Dis 1993; 181: 467-74.

Aaron LA, Bradley LA, Alarcon GS. Psychiatric diagnoses in patients with fibromyalgia are related to health care-seeking behavior rather than to illness. Arthritis Rheum 1996; 39: 436-45.

Bradley LA, Alarcon GS, Triana M, Aaron LA, Alexander RW, Stewart K, et al. Health care seeking behavior in fibromyalgia: associations with pain thresholds, symptom severity, and psychiatric morbidity. J Musculoskelet Pain 1994; 104: 79-87.

Gregory ES, Roy HP. Personalized Medicine for Depression: Can We Match Patients With Treatments? Am J Psychiatry 2010; 167: 1445-55.

Zyrianova Y, Kelly BD, Gallagher C, McCarthy C, Molloy MG, Sheehan J, et al. Depression and anxiety in rheumatoid arthritis: the role of perceived social support. Ir J Med Sci 2006; 175: 32-6.

Rugiene R, Dadoniene J, Venalis A, Stropuviene S. Comparison of health-related quality of life between patients with rheumatic diseases and a control group. Medicina (Kaunas) 2005; 41: 561-5.

Benitha R, Tikly M. Functional disability and health-related quality of life in South Africans with rheumatoid arthritis and systemic lupus erythematosus. Clin Rheumatol 2007; 26: 24-9.

Sherbourne CD, Wells KB, Hays RD, Rogers W, Burnam MA, Judd LL. Subthreshold depression and depressive disorder: clinical characteristics of general medical and mental health specialty outpatients. Am J Psychiatry 1994; 151: 1777-84.

Judd LL, Akiskal HS, Zeller PJ, Paulus MJ, Leon AC, Maser JD. Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry 2000; 57: 375-380.

Kessler LG, Cleari PD, Burke JD. Psychiatric disorders in primary care. Arch Gen Psychiatry 1995; 42: 583-7.

Garrard J, Rolnick SJ, Nitz NM, Luepke L, Jackson J, Fisher LR, et al. Clinical detection of depression among community-based elderly people with self-reported symptoms of depression. J Gerontol 1998; 53: 92.

Rifkin A. Depression in physically ill patients. Don’t dismiss it as dunderstandable T. Postgrad Med 1992; 92: 147-9.

Macfarlane GJ, Morris S, Hunt IM, Benjamin S, McBeth J, Papageorgiou AC, et al. Chronic widespread pain in the community: the influence of psychological symptoms and mental disorder on healthcare seeking behavior. J Rheumatol 1999; 26: 413-9.

McBeth J, Macfarlane GJ, Benjamin S, Morris S, Silman AJ. The association between tender points, psychological distress, and adverse childhood experiences: a community-based study. Arthritis Rheum 1999; 42: 1397-1404.<1397::AID-ANR13>3.0.CO;2-7

Tander B, Cengiz K, Alayli G. A comparative evaluation of health related quality of life and depression in patients with fibromyalgia syndrome and rheumatoid arthritis. Rheumatol Int 2008; 28: 859-65.

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Copyright (c) 2014 Sousan Kolahi, Ali Fakhari, Mehrzad Hajaliloo, Alireza Khabbazi, Sahar Hassanzadeh Dizaj, Mahdi Hemati