MURAT İLHAN ATAGÜN, Zeliha ATAGÜN, Cüneyt EVREN, Özlem Devrim BALABAN, Ebru Yılmaz YALÇINKAYA, Kadriye ÖNEŞ

Mental symptoms are related with impact of the disease and impairment in quality of life in female patients with fibromyalgia

Amaç: Fibromiyalji tanı ölçütleri, mental belirtiler dahil edilerek ve de hassas noktalar çıkarılarak 2010 yılında değiştirilmiştir. Yeni tanı ölçütlerinde ağrı hala en belirgin özellik olarak yerini korumaktadır, ancak yaşam kalitesi araştırmaları fibromiyaljinin depresyon, anksiyete, aleksitimi gibi yaşam kalitesinin mental bileşenleri ile ilişkili olduğunu göstermektedir. Bu araştırmada fibromiyaljide hastalık şiddeti ve yaşam kalitesinin belirleyicilerinin araştırılması hedeflendi. Yöntem: Ayakta izlenen ve fibromiyaljisi olan 57 kadın hasta (ortalama yaş±SS: 40.93±6.85; yaş aralığı: 24-56) çalışmaya alındı. Fibromiyalji Etki Anketi, Kısa Form-36, Beck Depresyon Ölçeği, Durumluluk-Süreklilik Kaygı Envanteri ve 20 maddelik Toronto Aleksitimi Skalası ölçüm araçlarıydı. Bulgular: Hastalık etki şiddetinin belirleyicisinin aleksitimi, özellikle de duyguları tanımada güçlük (DTG) faktörü olduğu tespit edildi. Yaşam kalitesinin fiziksel sağlık özetinin belirleyicisi yaş, mental sağlık özetinin belirleyicileri ise depresyon ve sürekli anksiyete puanlarıydı. Tartışma: Aleksitimi ve özellikle DTG alt birimi fibromiyalji belirtileri için yordayıcı olabilirken, depresyon ve anksiyete fibromiyalji için daha fazla yük getirici mental belirtiler olabilir. Fibromiyaljide ağrı ve mental semptomlar ayrı işleniyor gibi görünmektedir. Tedavide mental semptomların da ayrıca ele alınması tedavilerin başarı şansını artırabilir. Bu nedenle, psikiyatrinin de aralarında yer aldığı multidisipliner yaklaşımlara ihtiyaç vardır.

Fibromiyaljisi olan kadın hastalarda mental belirtilerin yaşam kalitesi ve hastalık şiddeti ile ilişkisi

Objective: Diagnostic criteria of fibromyalgia are revised in 2010 by including mental symptoms and excluding tender points. Although dominance of pain still prevails on the diagnostic criteria, quality of life (QoL) surveys showed that fibromyalgia is strongly associated with mental components of health status, i.e. depression, anxiety and alexithymia. It is aimed to assess determinants of QoL and impact of the disease in patients with fibromyalgia. Methods: Fifty seven female outpatients (mean age±SD: 40.93±6.85; age range: 24-56) with fibromyalgia were enrolled. Fibromyalgia Impact Questionnaire, Short Form-36 QoL survey, Beck Depression Inventory, State-Trait Anxiety Inventory, 20-item Toronto Alexithymia Scale were the measurement tools. Results: Predictor of impact of the disease was alexithymia, particularly, difficulty in identifying feelings (DIF) domain. Predictor of physical health was age, whereas predictors of mental health were depression and trait anxiety. Discussion: Alexithymia, particularly DIF domain may be a more specific predictor of fibromyalgia symptoms, whereas depression and anxiety are more burdensome mental symptoms for fibromyalgia. Pain and mental symptoms are seemed to be processed separately. Targeting mental symptoms may provide better treatment outcomes, thus multidisciplinary approaches including psychiatry are necessary.

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