Psychiatric diagnoses in patients with fibromyalgia are related to health care-seeking behavior rather than to illness.
OBJECTIVE
To compare the frequency of lifetime psychiatric disorders among 3 groups of subjects: patients with fibromyalgia syndrome (FMS) from a tertiary care setting, community residents with FMS who had not sought medical care for their FMS symptoms ("FMS nonpatients"), and healthy controls.


METHODS
We used the Computerized Diagnostic Interview Schedule to assess lifetime psychiatric diagnoses, as well as the Center for Epidemiological Studies Depression scale and the Trait Anxiety Inventory to assess current psychological distress, among 64 patients with FMS, 28 FMS nonpatients, and 23 healthy individuals.


RESULTS
Patients with FMS, relative to FMS nonpatients and healthy controls, were characterized by a significantly greater number of lifetime psychiatric diagnoses (P = 0.002). Nonpatients did not differ from controls in psychiatric diagnoses. Patients also exhibited higher psychological distress levels than nonpatients, and nonpatients showed greater distress than controls. Differences in psychological distress between patients and nonpatients were eliminated after controlling for pain threshold and fatigue ratings.


CONCLUSIONS
Psychiatric disorders are not intrinsically related to the FMS syndrome. Instead, multiple lifetime psychiatric diagnoses may contribute to the decision to seek medical care for FMS in tertiary care settings.
Aaron
L A
LA
School of Medicine, The University of Alabama at Birmingham, 35294-0006, USA.
Bradley
L A
LA
Alarcón
G S
GS
Alexander
R W
RW
Triana-Alexander
M
M
Martin
M Y
MY
Alberts
K R
KR
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D003710:Demography; D003863:Depression / Q000175:diagnosis; D005221:Fatigue / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D017288:Pain Threshold / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*