Familial aggregation of depression in fibromyalgia: a community-based test of alternate hypotheses The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. Sexual and Physical Abuse in Women With Fibromyalgia Syndrome: A Test of the Trauma Hypothesis Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Meditation awareness training for the treatment of fibromyalgia syndrome: A randomized controlled trial Psychiatric comorbidities in a community sample of women with fibromyalgia Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Changes associated with a quota-based approach on a walking program for individuals with fibromyalgia.
& NA ; Numerous studies report that fibromyalgia ( FM ) , a syndrome characterized by widespread pain and generalized tender points , is comorbid with major depressive disorder ( MDD ) . The current study tests two alternate explanations for their comorbidity using a family study methodology . The first is that FM is a depression spectrum disorder . The second is that depression is a consequence of living with FM . We recruited potential prob and s by initially screening by telephone for FM and MDD among women in the NY/NJ metropolitan area , r and omly selecting telephone numbers from a list of households with women . Eligible women were invited for second stage physical examinations for FM diagnosis and psychiatric interviews for MDD diagnosis . All available adult , first‐degree relatives received psychiatric interviews . Relatives of prob and s were divided into four groups on the basis of the prob and s ' FM and MDD diagnoses ( FM+/MDD+ ( n=156 ) , FM+/MDD− ( n=51 ) , FM−/MDD+ ( n=351 ) and FM−/MDD− ( n=101 ) ) . Results indicated that rates of MDD in the relatives of prob and s with FM but without personal histories of MDD were virtually identical to rates of MDD in relatives of prob and s with MDD themselves . This outcome is consistent with the hypothesis that FM is a depression spectrum disorder , in which FM and MDD are characterized by shared , familially mediated risk factors . The implication s of these findings for a stress‐vulnerability model of FM are discussed OBJECTIVE To estimate the point prevalence of fibromyalgia syndrome ( FM )  among noninstitutionalized Canadian adults ; and to assess the effect of demographic variables on the odds of having FM . METHODS A screening question naire was administered via telephone to a r and om community sample of 3395 noninstitutionalized adults residing in London , Ontario . Individuals screening positive were invited to be examined by a rheumatologist to confirm or exclude FM using the 1990 American College of Rheumatology classification criteria . RESULTS One hundred confirmed cases of FM were identified , of whom 86 were women . Mean age among FM cases was 49.2 years among women , 39.3 years among men ( p < 0.02 ) . FM affects an estimated 4.9 % ( 95 % CI 4.7 % , 5.1 % ) of adult women and 1.6 % ( 1.3 % , 1.9 % ) of adult men in London , for a female to male ratio of roughly 3 to one . In women , prevalence rises steadily with age from < 1 % in women aged 18 - 30 to almost 8 % in women 55 - 64 . Thereafter , it declines . The peak prevalence in men also appears to be in middle age ( 2.5 % ; 1.1 % , 5.7 % ) . FM affects 3.3 % ( 3.2 % , 3.4 % ) of noninstitutionalized adults in London . Female sex , middle age , less education , lower household income , being divorced , and being disabled are associated with increased odds of having FM . CONCLUSION FM is a common musculoskeletal disorder among Canadian adults , especially among women and persons of lower socioeconomic status Objectives : According to the trauma hypothesis , women with fibromyalgia syndrome ( FMS ) are more likely to report a history of sexual and /or physical abuse than women without FMS . In this study , we rely on a community sample to test this hypothesis and the related prediction that women with FMS are more likely to have posttraumatic stress disorder than women without FMS . Methods : Eligibility for the present study was limited to an existing community sample in which FMS and major depressive disorder were prevalent . The unique composition of the original sample allowed us to recruit women with and without FMS from the community . A total of 52 female participants were enrolled in the present FMS group and 53 in the control ( no FMS ) group .  Sexual and physical abuse were assessed retrospectively using a st and ardized telephone interview . Results : Except for rape , sexual and physical abuse were reported equally often by women in the FMS and control groups . Women who reported rape were 3.1 times more likely to have FMS than women who did not report rape ( P < 0.05 ) . There was no evidence of increased childhood abuse in the FMS group . Women with FMS were more likely to have posttraumatic stress disorder symptoms ( intrusive thoughts and arousal ) as well as posttraumatic stress disorder diagnosis ( P < 0.01 ) . Discussion : With the exception of rape , no self-reported sexual or physical abuse event was associated with FMS in this community sample . In accord with the trauma hypothesis , however , posttraumatic stress disorder was more prevalent in the FMS group . Chronic stress in the form of posttraumatic stress disorder but not major depressive disorder may mediate the relationship between rape and FMS OBJECTIVE To examine prospect ively the accuracy of an initial diagnosis for fibromyalgia ( FM ) . METHODS All patients newly referred for rheumatology consultation in a 6-month period were evaluated prospect ively for either a preceding , current or subsequent diagnosis of FM . Clinical characteristics , previous and subsequent management and health care utilization were assessed . The final diagnosis at 6 months was verified and accuracy regarding the diagnosis of FM was assessed . RESULTS Seventy six ( 12 % ) of all new patients were either referred with a question of FM or finally diagnosed with FM . At the final evaluation the accuracy of the diagnosis regarding FM by either the referring physician or by the rheumatologist at the time of the initial visit was correct in 34 % of patients . The FM group in comparison with those with some other rheumatological diagnosis had more tender points ( 12.5 vs 4 ) and were more fatigued . In contrast , prolonged early morning stiffness and limitation of lumbar spinal mobility in more than one plane was more common in the non-FM group . CONCLUSION There is a disturbing inaccuracy , mostly observed to be overdiagnosis , in the diagnosis of FM by referring physicians . This finding may help explain the current high reported rates of FM and caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain OBJECTIVES The purpose of this study was to conduct the first r and omized controlled trial ( RCT ) to evaluate the effectiveness of a second-generation mindfulness-based intervention ( SG-MBI ) for treating fibromyalgia syndrome ( FMS ) . Compared to first-generation mindfulness-based interventions , SG-MBIs are more acknowledging of the spiritual aspect of mindfulness . DESIGN A RCT employing intent-to-treat analysis . METHODS Adults with FMS received an 8-week SG-MBI known as meditation awareness training ( MAT ; n = 74 ) or an  active control intervention known as cognitive behaviour theory for groups ( n = 74 ) . Assessment s were performed at pre- , post- , and 6-month follow-up phases . RESULTS Meditation awareness training participants demonstrated significant and sustained improvements over control group participants in FMS symptomatology , pain perception , sleep quality , psychological distress , non-attachment ( to self , symptoms , and environment ) , and civic engagement . A mediation analysis found that ( 1 ) civic engagement partially mediated treatment effects for all outcome variables , ( 2 ) non-attachment partially mediated treatment effects for psychological distress and sleep quality , and ( 3 ) non-attachment almost fully mediated treatment effects for FMS symptomatology and pain perception . Average daily time spent in meditation was found to be a significant predictor of changes in all outcome variables . CONCLUSIONS Meditation awareness training may be a suitable treatment for adults with FMS and appears to ameliorate FMS symptomatology and pain perception by reducing attachment to self . Statement of contribution What is already known on this subject ? Design ing interventions to treat fibromyalgia syndrome ( FMS ) continues to be a challenge . There is growing interest into the applications of mindfulness-based interventions for treating FMS . Second-generation mindfulness-based interventions ( SG-MBIs ) are a key new direction in mindfulness research . What does this study add ? Meditation awareness training - an SG-MBI - result ed in significant reductions in FMS symptomatology . SG-MBIs recognize the spiritual aspect of mindfulness and may have a role in the treatment of FMS Abstract Prior studies of careseeking fibromyalgia ( FM ) patients often report that they have an elevated risk of psychiatric disorders , but biased sampling may distort true risk . The current investigation utilizes state‐of‐the‐art diagnostic procedures for both FM and psychiatric disorders to estimate prevalence rates of FM and the comorbidity of FM and specific psychiatric disorders in a diverse community sample of women . Participants were screened by telephone for  FM and MDD , by r and omly selecting telephone numbers from a list of households with women in the NY/NJ metropolitan area . Eligible women were invited to complete physical examinations for FM and clinician‐administered psychiatric interviews . Data were weighted to adjust for sampling procedures and population demographics . The estimated overall prevalence of FM among women in the NY/NJ metropolitan area was 3.7 % ( 95 % CI = 3.2 , 4.4 ) , with higher rates among racial minorities .  Although risk of current MDD was nearly 3‐fold higher in community women with than without FM , the groups had similar risk of lifetime MDD . Risk of lifetime anxiety disorders , particularly obsessive compulsive disorder and post‐traumatic stress disorder , was approximately 5‐fold higher among women with FM . Overall , this study found a community prevalence for FM among women that replicates prior North American studies , and revealed that FM may be even more prevalent among racial minority women . These community‐based data also indicate that the relationship between MDD and FM may be more complicated than previously thought , and call for an increased focus on anxiety disorders in FM OBJECTIVE To measure , and seek clinical correlates with , levels of  substance P ( SP ) in the cerebrospinal fluid ( CSF ) of fibromyalgia syndrome ( FMS ) patients . METHODS CSF from 32 FMS patients and 30 normal control subjects was tested for SP by radioimmunoassay . Clinical measures included tender point examination and st and ardized question naires . RESULTS CSF SP levels were 3-fold higher in FMS patients than in normal controls ( P < 0.001 ) , but they correlated only weakly with tenderness found on examination . CONCLUSION SP is significantly elevated in FMS CSF , but other abnormalities must exist in FMS to more fully explain the symptoms STUDY DESIGN Single-subject , multiple-baseline design across 3 subjects . OBJECTIVE To investigate the use of a quota-based approach to prescribing a walking program for individuals with fibromyalgia ( FM ) . BACKGROUND Exercise has been found to be beneficial for individuals with FM . What has not been determined is the best way to implement an exercise program that does not increase FM symptoms . METHODS AND MEASURES Three women with FM were r and omly assigned a baseline period of 5 , 6 , or 7 weeks , which served as the control phase , followed by an intervention period consisting of an 8-week walking program . The walking program progression was prescribed using a quota-based approach . Weekly outcome measures were the Fibromyalgia Impact Question naire ( FIQ ) , Arthritis Self-Efficacy Scale ( ASES ) , and SF-36v2 ( acute ) . A 6-minute walk test was recorded twice : at the start of the baseline phase ( after a trial phase ) and at the end of the intervention phase . RESULTS Subjects 1 and 3 had a significant decrease in the symptoms associated with FM during the intervention phase ( FIQ , P<.05 ) , but no significant increase in self-efficacy ( ASES ) . They increased their walking distances used for exercise by 640 and 480 m , respectively . Subject 2 had no significant improvements in her symptoms of FM . Despite a significant decrease in ASES ( P<.05 ) , walking distance used for exercise by subject 2 increased by 2080 m. Six-minute walk test distances increased 76 , 32 , and 106 m for subjects 1 , 2 , and 3 , respectively . CONCLUSIONS Prescribing a walking program using a quota-based exercise prescription result ed in increasing the distance walked for 3 subjects . It also decreased symptoms associated with FM in 2 of the 3 subjects , but did not increase self-efficacy
Invariably , their results suggested that homoeopathy was better than the control interventions in alleviating the symptoms of FM .
Homoeopathy is often advocated for fibromyalgia ( FM ) and many FM patients use it .