Depression and arthritis are common in primary care patients with fibromyalgia, according to a reassessment study of patient medical records. These symptoms’ prevalence was found to be significantly higher in female patients.
The study, “Gender-Stratified Prevalence of Psychiatric and Pain Diagnoses in a Primary Care Patient Sample with Fibromyalgia,” was published in the journal Pain Medicine.
Co-occurrence of other conditions (comorbidity) is common in patients with fibromyalgia. Conditions affecting mental health and those causing pain are frequently reported.
However, most of the information about this prevalence comes from specialists who can differentiate between the comorbidities and fibromyalgia, the authors wrote. Fibromyalgia diagnosis is difficult in a primary care setting because of the limited information available about these comorbidities.
Therefore, the authors reassessed medical records from Saint Louis University’s Primary Care Patient Data Registry to understand the distribution of such comorbidities among fibromyalgia patients in primary care.
Electronic medical records of 38,976 patients (mean age 47.2 years) were reanalyzed for this study. The patients were treated at three academic general internal medicine or family medicine clinics in the urban and suburban St. Louis area. The records covered a period between July 1, 2008, and June 30, 2016.
Of the 38,976 patients, 1,776 (4.6%) had fibromyalgia. Among those with fibromyalgia, there were more women (1,351) than men (425).
The different psychiatric comorbidities reported included depression, anxiety, post-traumatic stress disorder, other acute stress reaction, psychogenic disorders (physical illness caused by mental stressors), other mental illness that can manifest as a physical symptom (somatoform disorder), schizophrenia, or other delusional disorders.
Pain-associated comorbidities diagnosed in patients in this primary care setting are muscle pain, headache, arthritis, back pain, and neuropathy.
Of the comorbidities reported, the analysis showed that depression was the psychiatric condition and arthritis the pain-associated condition significantly prevalent in primary care patients with fibromyalgia. The prevalence of these conditions was markedly higher in women with fibromyalgia than men compared to those without fibromyalgia.
The depression diagnosis was 2.8 times more likely in women with fibromyalgia and 2.16 times in men with fibromyalgia, compared to those without fibromyalgia. Similarly, the chances of arthritis were 5.19 and 3.91 times higher in women and men with fibromyalgia, respectively, compared to those without fibromyalgia.
Overall, the comorbidities found in fibromyalgia patients in a primary care setting were similar to those in specialty care, the team noted.
“The vast majority of primary care physicians report difficulty distinguishing FM from other conditions. The present study may serve as a resource for a better understanding of FM as it presents in primary care,” the study concluded.
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