title: Advancing the screening of fibromyalgia in late-life depression: practical implications for psychiatric settings.
abstract: BACKGROUND
  Fibromyalgia (FM) is common in older adults suffering from mood disorders. However, clinical diagnosis of FM is challenging, particularly in psychiatric settings. We examined the prevalence of FM and the sensitivity of three simple screeners for FM.
  
  
  METHODS
  Using cross-sectional data, we evaluated three tests against the American College of Rheumatology (ACR) 1990 Criteria for the Classification of FM: a "Do you often feel like you hurt all over?" question, a pain map score, and the Pope and Hudson (PH) interview for FM. Participants were 185 community-dwelling adults ≥ 60 years old with comorbid depression and chronic low back pain evaluated at a late-life mental health clinic.
  
  
  RESULTS
  Fifty three of 185 participants (29%) met the ACR 1990 FM criteria. Compared to those without FM, the FM group had more "yes" answers to the "hurt all over?" question and higher pain map scores. To reach a sensitivity of at least 0.90, the cut-off score for the pain map was 8. The sensitivity of the pain map, "hurt all over?" question, and PH criteria were 0.92 [95%CI 0.82-0.98], 0.91 [95%CI 0.79-0.97], and 0.94 [95%CI 0.843-0.99] respectively.
  
  
  CONCLUSIONS
  Nearly one in three older adults suffering from depression and chronic low back pain met ACR 1990 FM criteria. Three short screening tests showed high sensitivity when compared to the ACR 1990 FM criteria. Implementation of one of the simple screeners for FM in geriatric psychiatry settings may guide the need for further diagnostic evaluation.
authors.affiliation: University of Pittsburgh School of Medicine,University of Pittsburgh,Pittsburgh,PA,USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Jochum
authors.affiliation: Department of Psychiatry,University of Pittsburgh School of Medicine,University of Pittsburgh,Pittsburgh,PA,USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Begley
authors.affiliation: Department of Psychiatry,University of Pittsburgh School of Medicine,University of Pittsburgh,Pittsburgh,PA,USA.
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.affiliation: Department of Psychiatry,University of Pittsburgh School of Medicine,University of Pittsburgh,Pittsburgh,PA,USA.
authors.forename: Debra K
authors.initials: DK
authors.lastname: Weiner
authors.affiliation: Department of Psychiatry,University of Pittsburgh School of Medicine,University of Pittsburgh,Pittsburgh,PA,USA.
authors.forename: Jordan F
authors.initials: JF
authors.lastname: Karp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis*; D006801:Humans; D017116:Low Back Pain / Q000150:complications*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010147:Pain Measurement / Q000592:standards*; D012372:ROC Curve; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: aging; depression; fibromyalgia; pain; screening