title: The impact of mood, anxiety, and sleep disorders on fibromyalgia.
abstract: BACKGROUND
  Several studies carried out mainly in North America revealed high rates of mood, anxiety and sleep disorders in patients with fibromyalgia (FM), while the information in other countries is scant. Therefore, we aimed at investigating the prevalence and the impact of such conditions on the health-related quality of life (HRQoL) and the severity of pain in a sample of Italian FM patients.
  
  
  METHODS
  One-hundred and sixty-seven women suffering from primary FM were consecutively enrolled. Psychiatric diagnoses were made by means of DSM-IV criteria. The HRQoL and the severity of pain were measured through the Medical Outcomes Study 36-item Short-Form Health Survey (MOS-SF-36) and the FM Impact Questionnaire (FIQ).
  
  
  RESULTS
  Fibromyalgia patients showed a high rate (80.8%) of lifetime and/or current comorbidity with mood and anxiety disorders. Patients with psychiatric comorbidity resulted significantly more impaired on the Mental Component Summary score of the MOS-SF-36 and showed a higher FIQ total score than those suffering from FM only. The severity of pain was associated with current psychiatric comorbidity. Patients with current mood disorders showed significantly lower Mental and Physical Component Summary scores of the MOS-SF-36 and higher FIQ total scores than those with current anxiety disorders or those without psychiatric comorbidity. Finally, patients with sleep disorders reported a lower HRQoL than those with a normal sleep, and specifically those with difficulty in falling in sleep had higher severity of pain.
  
  
  CONCLUSIONS
  Psychiatric comorbidity, in particular with mood disorders, provokes a significant impairment of the HRQoL and, when current, a higher severity of pain in FM patients.
authors.affiliation: Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie bDipartimento di Medicina Interna, Unità di Reumatologia, University of Pisa, Pisa, Italy. consoli_giorgio@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Consoli
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciapparelli
authors.forename: Laura
authors.initials: L
authors.lastname: Bazzichi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Massimetti
authors.forename: Camillo
authors.initials: C
authors.lastname: Giacomelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires