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.

Kaynakça

1. Wolfe F, Smythe HA, Yunus MB, Benett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33:160-172.

2. Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol 2003; 17:685-701.

3. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62:600-610.

4. Ataoğlu S, Özçetin A, Ataoğlu A, İçmeli C, Makarç S, Yağlı M. The relationship pain intensity, anxiety, and depression in patients with fibromyalgia and rheumatoid arthritis. Anatolian Journal of Psychiatry 2002; 3:223-226.

5. Stahl SM. Antidepressants and somatic symptoms: therapeutic actions are expanding beyond affective spectrum disorders to functional somatic syndromes. J Clin Psychiatry 2003; 64:745-746.

6. Maletic V, Raison CL. Neurobiology of depression, fibromyalgia and neuropathic pain. Front Biosci 2009; 14:5291-5338.

7. Evren B, Evren C, Yapıcı A, Hoşafçı Güler M. Fibromyalji hastalarında ağrı şiddeti ile psikiyatrik belirtiler arasındaki ilişki. Anatolian Journal of Psychiatry 2005; 6:69-74. (Article in Turkish).

8. Yunus MB. Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. Best Pract Res Clin Rheumatol 2007; 21:481-497.

9. Evren B, Evren C, Hosafci Guler M. An open clinical trial of venlafaxine in the treatment of pain, depressive and anxiety symptoms in fibromyalgia. The Pain Clinic 2006; 18:167-173.

10. Gormsen L, Rosenberg R, Bach FW, Jensen TS. Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. Eur J Pain 2010; 14:127.

11. Lumley MA, Smith JA, Longo DJ. The relationship of alexithymia to pain severity and impairment among patients with chronic myofascial pain. Comparisons with self-efficacy, catastrophising, and depression. J Psychosom Res 2002; 53:823-830.

12. Sayar K, Güleç H, Topbas M. Alexithymia and anger in patients with fibromyalgia. Clin Rheumatol 2004; 23:441-448.

13. Aguglia A, Salvi V, Maina G, Rossetto I, Aguglia E. Fibromyalgia syndrome and depressive symptoms: comorbidity and clinical correlates. J Affect Disord 2011; 128:262-266.

14. Evren B, Evren C, Hosafci Guler M. Clinical correlates of alexithymia in patients with fibromyalgia. The Pain Clinic 2006; 18:1-9.

15. Sturge-Jacobs M. The experience of living with fibromyalgia: confronting an invisible disability. Res Theory Nurs Pract 2002; 16:19-31.

16. Birtane M, Uzunca K, Tastekin N, Tuna H. The evaluation of quality of life in fibromyalgia syndrome: a comparison with rheumatoid arthritis by using SF-36 health survey. Clin Rheumatol 2007; 26:679-684.

17. Tander B, Cengiz K, Alayli G, Ilhanli I, Canbaz S, Canturk F. A comparative evaluation of health related quality of life and depression in patients with fibromyalgia syndrome and rheumatoid arthritis. Rheumatol Int 2008; 28:859-865.

18. Walker EA, Keegan D, Gardner G, Sullivan M, Katon WJ, Bernstein D. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: I. Psychiatric diagnoses and functional disability. Psychosom Med 1997; 59:565-571.

19. Hoffman DL, Dukes EM. The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12. Int J Clin Pract 2008; 62:115-126.

20. Ozcetin A, Ataoglu S, Kocer E, Yazici S, Yildiz O, Ataoglul A, Icmeli C. Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome. West Indian Med J 2007; 56:122-129.

21. Burckhardt CS, Clark SR, Bennett RM. The Fibromyalgia Impact Questionnaire: Development and validation. J Rheumatol 1991; 18:728-733.

22. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000; 20:9-12.

23. Bagby RM, Parker JDA, Taylor GJ. The 20-Item Toronto- Alexithymia-Scale-I. Item selection and cross-validation of the factor structure. J Psychosom Res 1994; 38:23-32.

24. Bagby RM, Taylor GJ, Parker JDA. The 20-Item Toronto- Alexithymia-Scale-II. Convergent, discriminant, and concurrent validity. J Psychosom Res 1994; 38:33-40.

25. Güleç H, Köse S, Güleç MY Çıtak S, Evren C, Borckardt J, Sayar K. Reliability and factorial validity of the Turkish version of the 20-item Toronto alexithymia scale (TAS-20) Bulletin of Clinical Psychopharmacology. 2009; 19:213-219.

26. Hisli N. Beck depresyon ölçeğinin bir Türk örnekleminde geçerlilik ve güvenilirliği. Psikoloji Dergisi 1988; 6:118-122. (Article in Turkish)

27. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4:561-571.

28. Spielberger CD, Gorsuch RL, Lushene RE. State-Trait Anxiety Inventory (Self-evaluation questionnaire). Palo Alto: Consulting Psychologists Press, 1970.

29. Öner N, LeCompte A. Durumluluk-süreklilik kaygı envanteri el kitabı. İstanbul: Boğaziçi Universitesi Yayınları, 1982. (Article in Turkish)

30. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30:473-483.

31. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. Kısa Form-36’nın (KF-36) Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilac ve Tedavi Dergisi 1999; 12:102-106. (Article in Turkish)

32. Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kivircik B, Alptekin K. Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population. BMC Public Health 2006; 6:247.

33. De Gucht V, Fischler B, Heiser W. Personality and affect as determinants of medically unexplained symptoms in primary care; A follow-up study. J Psychosom Res 2004; 56:279-285.

34. Huber A, Suman AL, Biasi G, Carli G. Alexithymia in fibromyalgia syndrome: Associations with ongoing pain, experimental pain sensitivity and illness behavior. J Psychosom Res 2009; 66:425– 433.

35. Lumley MA, Radcliffe AM, Macklem DJ, Mosley-Williams A, Leisen JCC, D’Souza PJ, Gillis ME, Meyer TM, Kraft CA, Rapport LJ. Alexithymia and pain in three chronic pain samples: Comparing Caucasians and African Americans. Pain Med 2005; 6:251–261.

36. Mattila AK, Kronholm E, Jula A, Salminen JK, Koivisto AM, Mielonen R, Joukamaa D. Alexithymia and somatization in general population. Psychosom Med 2008; 70:716–722.

37. Porcelli P, Tulipani C, Maiello E, Cilenti G, Todarello O. Alexithymia, coping, and illness behavior correlates of pain experience in cancer patients. Psychooncology 2007; 16:644–650.

38. Lane RD, Lee S, Reidel R, Weldon V, Kaszniak A, Schwartz G. Impaired verbal and nonverbal emotion recognition in alexithymia. Psychosom Med 1996; 58:203–210.

39. Lumley MA, Neely LC, Burger AJ. The assessment of alexithymia in medical settings: Implications for understanding and treating health problems. J Pers Assess 2007; 89:230-246.

40. Petrak F, Hardt J, Kappis B, Nickel R, Tiber Egle U. Determinants of health-related quality of life in patients with persistent somatoform pain disorder. Eur J Pain 2003; 7:463-471.

41. Hallberg LR, Carlsson SG. Anxiety and coping in patients with chronic work-related muscular pain and patients with fibromyalgia. Eur J Pain 1998; 2:309-319.

42. Edwards RR, Bingham CO 3rd, Bathon J, Haythornthwaite JA. Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Rheum 2006; 55:325-332.

43. Hassett AL, Cone JD, Patella SJ, Sigal LH. The role of catastrophizing in the pain and depression of women with fibromyalgia syndrome. Arthritis Rheum 2000; 43:2493-2500.

44. Roth RS, Geisser ME, Theisen-Goodvich M, Dixon PJ. Cognitive complaints are associated with depression, fatigue, female sex, and pain catastrophizing in patients with chronic pain. Arch Phys Med Rehabil 2005; 86:1147-1154.

45. Müller W, Schneider EM, Stratz T. The classification of fibromyalgia syndrome. Rheumatol Int 2007; 27:1005-1010.

46. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995; 38:19-28.

Kaynak Göster

  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984

5.4b 3.3b

Sayıdaki Diğer Makaleler

Persekütuar tip sanrısal bozuklukta bütünleyici psikoterapi yaklaşımı: Bir olgu sunumu

F.Işıl BİLİCAN, Mustafa ÖVÜL

Sexual function and satisfaction of women with vaginismus

Ramazan KONKAN, Meltem BAYRAK, Oya Güçlü GÖNÜLLÜ, ÖMER ŞENORMANCI, Mehmet Z. SUNGUR

Anevrizma nedeniyle opere edilen hastada gelişen organik kişilik sendromu: Bir olgu sunumu

PINAR GÜZEL ÖZDEMİR, Yavuz SELVİ, Adem AYDIN

Evaluation of burden in a group of patients with chronic psychiatric disorders and their caregivers

Muharrem AK, Fatih YAVUZ, Nergis LAPSEKİLİ, MEHMET HAKAN TÜRKÇAPAR

Defense styles that are related with history of self-mutilation and suicide attempt in alcohol dependent inpatients

Cüneyt EVREN, Serap ÖZÇETİNKAYA, Dilara ÇAĞIL, Müge ÜLKÜ, FATMA YEŞİM CAN, ELİF MUTLU

Venlafaxine-induced restless legs syndrome

AYSEL MİLANLIOĞLU

Examination of psychometric properties of the Turkish version form of the oxford happiness questionnaire in university students

Tayfun DOĞAN, Fatma SAPMAZ

Çocuk ve ergenlerde tik bozuklukları: Klinik ve etiyolojik bir bakış

SELMA TURAL HESAPÇIOĞLU

Cigarette smoking in patients with schizophrenia in Turkey: Relationships to psychopathology, socio-demographic and clinical characteristics

OKAN EKİNCİ, Aslı EKİNCİ

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

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