The prevalence of psychiatric and chronic pain comorbidities in fibromyalgia: An ACTTION systematic review, 2020, Kleykamp et al

[Sly Saint]

Abstract
Fibromyalgia (FM) is a chronic widespread pain condition that overlaps with multiple comorbid health conditions and contributes to considerable patient distress.

The aim of this review was to provide a systematic overview of psychiatric and chronic pain comorbidities among patients diagnosed with FM and to inform the development of recommendations for the design of clinical trials.
Thirty-one, cross-sectional, clinical epidemiology studies that evaluated patients diagnosed with FM were included for review. None of the reviewed studies reported on the incidence of these comorbidities. Sample size-weighted prevalence estimates were calculated when prevalence data were reported in 2 or more studies for the same comorbid condition.

The most prevalent comorbidity across all studies reviewed was depression/major depressive disorder (MDD) with over half of the patients included having this diagnosis in their lifetime (weighted prevalence up to 63%). In addition, nearly one-third of FM patients examined had current or lifetime bipolar disorder, panic disorder, or post-traumatic stress disorder. Less common psychiatric disorders reported included generalized anxiety disorder, obsessive compulsive disorder, and specific phobias (agoraphobia, social phobia).

There were fewer studies that examined chronic pain comorbidities among FM patients, but when evaluated, prevalence was also high ranging from 39% to 76% (i.e., chronic tension-type or migraine headache, irritable bowel syndrome, myofascial pain syndrome, and temporomandibular disorders).

The results of the review suggest that depression and chronic pain conditions involving head/jaw pain and IBS were elevated among FM patients compared to other conditions in the clinic-based studies. In contrast, anxiety-related disorders were much less common. Addressing the presence of these comorbid health conditions in clinical trials of treatments for FM would increase the generalizability and real-world applicability of FM research.

https://www.sciencedirect.com/science/article/abs/pii/S0049017220303012?dgcid=rss_sd_all

 

[Arnie Pye]

This strikes me as being just a fishing expedition. They haven't said why they want to do clinical trials, so they probably just want to test CBT and GET on people with fibromyalgia, and possibly increase the use of psychiatric drugs on patients.

 

[rvallee]

This is of no value to anyone. It does not inform about anything. Doesn't advance knowledge in any way shape or form.

So what's the point of doing stuff like this again and again? Complete waste of resources.

 

[shak8]

31 clinical epidemiological studies of fibromyalgia yielded the most common co-morbidity is depression, and then further incidences of PTSD, bipolar, etc.

My question is: since about 1/3 of American women have a history of abuse in childhood or rape in their teens and beyond, none of these associations (i.e.PTSD) surprise me.

And, I would have to see how representative the samples are in the 31 studies. Are they primarily taken from tertiary care centers (major hospitals, sometime university connected medical centers) that tend to treat the most complex patients?

Abstract says: Lifetime or concurrent depression diagnosis...63% in fibro pts. Not surprising. Depression is very common in women at some point (divorce, death of a close relative, a pet, job loss, illness, yes..illness). Fibromyalgia is very depressing and involves multiple role losses and depression is expected, imo, until successful adaptation occurs, incrementally.


The abstract concludes:

"Addressing the presence of these comorbid health conditions in clinical trials of treatments for FM would increase the generalizability and real-world applicability of FM research."

What does that mean, really? More funding opportunities?

 

[alktipping]

any trawl of historic medical notes will not give you evidence of anything other than a snapshot of the doctors subjective opinion of the patient . considering the frequent post i have seen about the abysmal record keeping and constant misdiagnosis by medical professionals i would not come to any conclusion whatsoever based on this kind work .

 

[rvallee]

any trawl of historic medical notes will not give you evidence of anything other than a snapshot of the doctors subjective opinion of the patient . considering the frequent post i have seen about the abysmal record keeping and constant misdiagnosis by medical professionals i would not come to any conclusion whatsoever based on this kind work .

I just realized that basically medicine is failing at sanitizing inputs. Oh boy. Now that's just about the most elementary technical failure out there. Oof. It's different but basically comes out the same.

Basically in software development, whenever you deal with user input you have to sanitize it to prevent nasty stuff. This is usually how hacks happen: unsanitized input that inject code where there shouldn't be. This is the most basic aspect of security, the first line of defense: assume all inputs are invalid and clean them up. Also: assume they're wrong and validate all the things. Twice, ideally. It's also why it's so expensive to deal with large data sets: data sets are only valid as their integrity, how accurate they are. Any serious process does layers of sanity checks and validation to make sure the input is actually accurate.

GIGO. GIGO is what you get when you assume infallibility of input. Holy hubris. Never trust inputs, people put all sort of nonsense there.