Most Fibromyaglia Victims are Not Depressed, yet study after study has shown it to be higher than in comparable populations. Why is that? I suggest it is:
- the uncertainly that goes with the diagnosis (do I have something more serious?)
- the need for continued search for primary and secondary pain generators
- the stigmatization that comes from having an invisible disease
- the poverty and struggle one has when dealing with insurers
WOMEN WITH FIBROMYAGLIA!
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——————Two recent studies have shown there is more depression in FM than other comparable illnesses:
Eur J Pain. 2010 Feb;14(2):127.e1-8.
Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain.
Gormsen L, Rosenberg R, Bach FW, Jensen TS. abstract here
Incidence of Depression: FM 7.1% Neuropathic pain – 3.3%
J Rheumatol. 2010 Feb;37(2):305-15. Epub 2010 Jan 15.
Chronic conditions and health problems in rheumatic diseases: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, systemic lupus erythematosus, and fibromyalgia.
Wolfe F, Michaud K, Li T, Katz RS. abstract here
Incidence of Depression:
- FM – 39% (much higher but suspect teriary referral center patients worse)
- Rheumatoid arthritis or Non inflammatory Rheumatic Disorders – 14%
- SLE – 34% (this group can get pretty sick and the steroids they may be on can induce depression)
Had one case in which I ask if she would have preferred to have Multiple Sclerosis – a disease that can progress to putting one in a wheelchair. The answer was yes – then you would know what you are dealing with, the treatments are more well defined, and it is a more recognized disorder. Insurance issues are less confrontational.
We know that FM is not an insurance related disease:
The Amish have it at same or maybe more frequent incidence of Fibromyalgia:
J Rheumatol. 2003 Aug;30(8):1835-40.
Fibromyalgia syndrome in an Amish community: a controlled study to determine disease and symptom prevalence.
White KP, Thompson J abstract here
It has same prevalence in third world countries despite no insurance coverage:
Prevalence of rheumatic diseases in Brazil: a study using the COPCORD approach.
Erika Rodrigues Senna, Ana Letícia P De Barros, Edvânia O Silva, Isabella F Costa, Leonardo Victor B Pereira, Rozana Mesquita Ciconelli, and Marcos Bosi Ferraz
The Journal of Rheumatology March 1, 2004 vol. 31 no. 3 594-597 abstract here
The contention Fibromyalgia might be a viral infection, refuses to die, with the contention the blood testing in the British study was inadequate.
The stigmatization that goes with the disease can be enormous with a few doctors even refusing to see such patients.
Rheumatologists can be hard on these patients and have been on occasion censored by our Medical College here.
One nauseating story was of a Rheumatologist that refused to ever consider FM disabling, yet when a secretary in his department developed FM, he refused to take her on because she was too slow and had other performance issues, would forget thengs, and may miss days at work. What a hipocrite…