used as a screening measure of general psychiatric symptomatology. It
includes dimensions measuring somatization, obsessive-compulsive,
depression, anxiety, phobic anxiety, hostility, interpersonal
sensitivity, paranoid ideation, and psychoticism. The inclusion of
somatic items (physical symptoms) may cause an overestimation of
psychiatric symptoms.
This study suggests that a blanket assumption of psychological
co-morbidities in fibromyalgia is unwarranted. Some ME and CFS
researchers also separate patients with psychiatric co-morbidities
from patients without such comorbidities. The failure to do so may
further muddy the scientific literature as may the inclusion of people
with affective disorders only. It is unknown from reading the
abstract what the premorbid SCL-90-R score might have been for type II
although it is a variable that may play a role as well. Psychological
issues are not known to confer immunity from organic disease.
Rheumatol Int. 2011 Nov 8. [Epub ahead of print]
Is psychological distress intrinsic to fibromyalgia syndrome?
Cross-sectional analysis in two clinical presentations.
Salgueiro M, Aira Z, Buesa I, Bilbao J, Azkue JJ.
Department of Neurosciences, School of Medicine and Dentistry,
University of the Basque Country, PO Box 699, 48080, Leioa, Bilbao,
Bizkaia, Spain.
Abstract
Clinical presentation of fibromyalgia syndrome (FMS) is heterogeneous
and often involves psychological comorbidities. Clinical subgrouping
of FMS patients has been proposed as a strategy to improve patients'
long-term outcomes by helping identify specific treatment needs. Using
the 90 Symptom Checklist Revised (SCL-90-R), we have assessed
emotional distress in two FMS patient subpopulations discriminated on
the basis of their differences in scores on specific items of the
Fibromyalgia Impact Questionnaire (FIQ).
Subjects classed as type II exhibited high emotional distress on all
ten dimensions studied, which included somatization,
obsessive-compulsive, interpersonal sensitivity, depression, anxiety,
hostility, phobic anxiety, paranoid ideation, psychoticism, and
additional items subscales, as well as on the global severity index
(GSI), positive symptom total (PST), and positive symptom distress
index (PDSI). T-scores in these patients were above diagnostic cutoff
level of 60 on somatization, obsessive-compulsive, and depression
subscales.
In contrast, the profile exhibited by type I subjects fell entirely
within normal values for nonpsychiatric population.
Emotional status was significantly inversely correlated with present
clinical pain in type I-, but not in type II-fibromyalgia patients.
Regression analysis revealed a model based on phobic anxiety, paranoid
ideation, and depression subscales as best contributing to
classification.
The present data suggest that associated psychological distress and
maladaptive emotional responses that are commonly attributed to the
general FMS population may be largely a distinguishing feature of one
subset of patients.
PMID: 22065070 [PubMed - as supplied by publisher]
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