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Bidirectional Association Between Depression and Fibromyalgia Syndrome: A Nationwide Longitudinal Study

萧条(经济学) 医学 危险系数 纤维肌痛 置信区间 共病 内科学 比例危险模型 疾病 纵向研究 流行病学 精神科
作者
Meng Han Chang,Ju Wei Hsu,Kai Lin Huang,Tung Ping Su,Ya Mei Bai,Cheng Ta Li,Albert C. Yang,Wen Han Chang,Tzeng Ji Chen,Shih-Jen Tsai,Mu Hong Chen
出处
期刊:The Journal of Pain [Elsevier BV]
卷期号:16 (9): 895-902 被引量:63
标识
DOI:10.1016/j.jpain.2015.06.004
摘要

Several cross-sectional studies have reported a common comorbidity between depression and fibromyalgia syndrome (FMS). However, a bidirectional temporal association between these 2 distinct diseases has rarely been investigated. Using the Taiwan National Health Insurance Research Database, 25,969 patients with FMS and without any psychiatric disorder and 17,142 patients with depression and without FMS between 2000 and 2008 were enrolled and separately compared with age- and sex-matched (1:4) control groups. Patients with FMS who developed a new-onset depression and those with depression who developed new-onset FMS were identified during follow-up (to the end of 2011). The conditional Cox regression analyses, after adjustment for demographic data and medical comorbidities, showed that the patients with FMS were associated with an increased risk (hazard ratio [HR] 7.46, 95% confidence interval [CI] 6.77-8.22) of subsequent depression and that those with depression were associated with an increased risk (HR 6.28, 95% CI 5.67-6.96) of subsequent FMS. Our results supported a bidirectional temporal association between depression and FMS. Each disease occurring first may increase the risk of the other subsequently. Further study may be necessary to determine the underlying mechanism between depression and FMS and to clarify whether a prompt intervention for depression or FMS may decrease the risk of the other later in life. Perspective: Our study supported a bidirectional temporal association between depression and FMS such that each disease occurring first may increase the risk of the other subsequently. This result may imply a shared pathophysiology between FMS and depression, but further investigation is needed.
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