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Fibromyalgia and dissociative symptoms

Published online by Cambridge University Press:  21 March 2019

Juan Manuel Duarte Open the ORCID record for Juan Manuel Duarte [Opens in a new window] ,
Catherine Crow ,
Ariel Antik ,
Francisco Appiani  and
Alejandro Caride
Juan Manuel Duarte*
Affiliation:
Department of Neurosciences, Deutsches Hospital, Buenos Aires, Argentine Republic
Catherine Crow
Affiliation:
Rheumatology Unit, Deutsches Hospital, Buenos Aires, Argentine Republic
Ariel Antik
Affiliation:
Hospital de Agudos “Carlos Durand”, Gobierno de la Ciudad de Buenos Aires, Buenos Aires, Argentine Republic
Francisco Appiani
Affiliation:
Neuropsychopharmacology Unit, University Hospital “José de San Martin”, University of Buenos Aires, Buenos Aires, Argentine Republic
Alejandro Caride
Affiliation:
Department of Neurosciences, Deutsches Hospital, Buenos Aires, Argentine Republic
*
*Address correspondence to: Juan Manuel Duarte, Deutsches Hospital, Hospital Alemán. Department of Neurosciences. Av Pueyrredón 1640, Ciudad Autónoma de Buenos Aires (C1118AAT), Argentine Republic. (Email: jduarte@hospitalaleman.com)
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Abstract

Background

Fibromyalgia (FM) is a chronic pain syndrome with a controversial etiopathogenesis. Patients with FM usually complain of cognitive symptoms, which are described as “fibrofog.” These cognitive complaints might be caused partially by dissociative disorders (DD). The aim of this research is to determine the association between FM and DD.

Methods

The authors conducted a case-control study for this purpose, integrated by 3 groups: control (C), patients with rheumatic disorders (R), and patients with FM (FM), who were compared through the Dissociative Experiences Scale (DES).

The findings are as follows: 42% were taking medications in the FM group, and their differences in scores with those who were not under medications were then considered. In terms of the results, the FM group showed higher scores than both C and R groups (p < 0.05). Patients with FM who were taking antidepressants had lower scores than those who were not (Z-score –8.03; p < 0.05); and finally, 5.71% had a score over 30 (χ2 = 3.73, p = 0.15).

Conclusion

Patients with FM had higher scores, which might be related to the association of dissociative experiences, lifetime trauma, and victimization. Antidepressants might have some role on dissociative symptoms as well.

Keywords

Dissociationdissociative disorderfibromyalgiapain
Type
Original Research
Information
CNS Spectrums , Volume 24 , Issue 6 , December 2019 , pp. 605 - 608
Copyright
© Cambridge University Press 2019 

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References

Yunus, M, Masa, AT, Calabro, JJ, Miller, KA, Fergebaum, SL. Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum. 1981; 11(1): 151–174.CrossRefGoogle ScholarPubMed
Talotta, R, Bazzichi, L, Di Franco, M, et al. One year in review 2017: fibromyalgia. Clin Exp Rheumatol. 2017; 35 Suppl 105(3): 6–12.Google ScholarPubMed
Wolfe, F, Smythe, HA, Yunus, MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990; 33(2): 160–172.CrossRefGoogle ScholarPubMed
Wolfe, F, Clauw, DJ, Fritzcharles, MA, et al. The American College of Rheumatology preliminary criteria for fibromyalgia and symptom severity. Arthritis Care Res (Hoboken). 2010; 62(5): 600–610.CrossRefGoogle ScholarPubMed
Brenes, JR, Tenorio, OC. Fibromialgia. Rev Med Costa Rica. 2010; 67(591): 93–96.Google Scholar
Haviland, MG, Morton, KR, Oda, K, Fraser, GE. Traumatic experiences, major life stressors and self reporting a physician-given fibromyalgia diagnosis. Psychiatry Res. 2010; 177(3): 335–341.CrossRefGoogle ScholarPubMed
Quevedo, H. Increased prevalence of fibromyalgia in a medical centre: an observational study comparing years 2009–2011. Interciencia. 2012; 3(4): 5–9Google Scholar
Ojeda, B, Salazar, A, Dueñas, M, Failde, I. Cognitive impairment: a factor to consider in the assessment and intervention of chronic pain patients. Rev Soc Esp Dolor. 2011; 18(5): 291–296.Google Scholar
Katz, RS, Heard, AR, Mills, M, Leavitt, F. The prevalence and clinical impact of reported cognitive difficulties (fibrofog) in patients with rheumatic disease with and without fibromyalgia. J Clin Rheumatol. 2004; 10(2): 53–58.CrossRefGoogle ScholarPubMed
Bertolucci, PH, de Oliveira, FF. Cognitive impairment in fibromyalgia. Curr Pain Headache Rep. 2013; 17(7): 344.CrossRefGoogle ScholarPubMed
Tesio, V, Torta, DM, Colonna, F, et al. Are fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence. Arthritis Care Res (Hoboken). 2015; 67(1): 143–150.CrossRefGoogle ScholarPubMed
Montoro, CI, Duschek, S, Ladron de Guevara, CM, Fernandez-Serrano, MJ, Reyes del Paso, GA. Aberrant cerebral blood flow responses during cognition: implications for the understanding of cognitive deficits in fibromyalgia. Neuropsychology. 2015; 29(2): 173–182.CrossRefGoogle ScholarPubMed
Allegre, J. Fibromyalgia is a primary pain condition. Is there cognitive impairment in Fibromyalgia? Rev Soc Esp Dolor. 2008; 6: 355–357.Google Scholar
Spiegel, D, Loewenstein, RJ, Lewis-Fernández, R, et al. Dissociative disorders in DSM-5. Depress Anxiety. 2011; 28(9): 524–552.CrossRefGoogle ScholarPubMed
Leavitt, F, Katz, RS, Mills, M, Heard, AR. Cognitive and dissociative manifestations in fibromyalgia. J Clin Rheumatol. 2002; 8(2): 77–84.CrossRefGoogle ScholarPubMed
Näring, GWB, van Lankveld, W, Greenen, R. Somatoform dissociation and traumatic experiences in patients with rheumatoid arthritis and fibromyalgia. Clin Exp Rheumatol. 2007; 25(6): 872–875.Google ScholarPubMed
Bernstein, EM, Putman, FW. Development, reliability and validity of a dissociation scale. J Nerv Ment Dis. 1986; 174(12): 727–735.CrossRefGoogle ScholarPubMed
Icaran, E, Colom, R, Orengo-Garcia, F. [Validation study of the dissociative experiences scale in a Spanish population simple]. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1996; 24(1): 7–10.Google Scholar
Peres, JF, Moreira-Almerida, A, Caixeta, L, Leao, F, Newberg, A. Neuroimaging during trance state: a contribution to the study of dissociation. PLoS One. 2012; 7(11): e49369.CrossRefGoogle Scholar
Najavits, L, Walsh, M. Dissociation, PTSD and substance abuse: an empirical study. J Trauma Dissociation. 2012; 13(1): 115–126.CrossRefGoogle Scholar
Vermetten, E, Schmahl, C, Lindner, S, Loewenstein, RJ, Bremner, JD. Hyppocampal and amygdalar volumes in dissociative identity disorder. Am J Psychiatry. 2006; 163(4): 630–636.CrossRefGoogle Scholar
Bremner, JD. Neuroimaging in post-traumatic stress disorder and other stress related disorders. Neuroimaging Clin N Am. 2007: 17(4): 523–538.CrossRefGoogle ScholarPubMed
Ablin, JN, Buskila, D, Clauw, DJ. Biomarkers in fibromyalgia. Curr Pain Headache Rep. 2009; 13(5): 343–349.CrossRefGoogle ScholarPubMed
Oliveira, TF, Paiva, T, Sanches, JM. Dissociated states in fibromyalgia. http://www.useds.isr.ist.utl.pr/mypapers/2010_RecPad_TaniaOliveira.pdf. Accessed November 30, 2017.Google Scholar
Leavitt, F, Katz, RS, Mills, M, Heard, AR. Cognitive and dissociative manifestations in fibromyalgia. J Clin Rheumatol. 2002; 8(2): 77–84.CrossRefGoogle ScholarPubMed
Berkol, TD, Balcioglu, YH, Kirlioglu, SS, Erensoy, H, Vural, M. Dissociative features of fibromyalgia syndrome. Neurosciences. 2017; 22(3): 198–204.CrossRefGoogle ScholarPubMed
Boomershine, CS, Crofford, LJ. A symptom-based approach to pharmacologic management of fibromyalgia. Nat Rev Rheumatol. 2009; 5(4): 191–199.CrossRefGoogle ScholarPubMed
Arnold, LM, Russell, IJ, Diri, EW, et al. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain. 2008; 9(9): 792–805.CrossRefGoogle ScholarPubMed
Ohta, H, Oka, H, Ohkura, M, Suzuki, M, Nishioka, K. A randomized, double-blind, multicenter, placebo controlled phase III trial to evaluate the efficacy and safety of pregabalin in Japanese patients with fibromyalgia. Arthritis Res Ther. 2012; 14(5): R217.CrossRefGoogle ScholarPubMed
Kia, S, Choi, E. Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines. 2017; 5(2): 20.CrossRefGoogle ScholarPubMed
Kilic, O, Sar, V, Taycan, O, et al. Dissociative depression among women with fibromyalgia or rheumatoid arthritis. J Trauma Dissociation. 2014; 15(3): 285–302.CrossRefGoogle ScholarPubMed
Kienle, J, Rockstroh, B, Bohus, M, Fiess, J, Huffziger, S, Steffen-Klatt, A. Somatoform dissociation and posttraumatic stress syndrome—two sides of the same medal? A comparison of symptom profiles, trauma history and altered affect regulation between patients with functional neurological symptoms and patients with PTSD. BMC Psychiatry. 2017; 17(1): 248.CrossRefGoogle ScholarPubMed
Burke, NN, Finn, DP, McGuire, BE, Roche, M. Psychological stress in early life as a predisposing factor for the development of chronic pain: clinical and preclinical evidence and neurobiological mechanisms. J Neurosci Res. 2017; 96(6): 1257–1270.CrossRefGoogle Scholar
Walker, EA, Keegan, D, Gardner, G, Sullivan, M, Bernstein, D, Katon, WJ. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect. Psychosom Med. 1997; 59(6): 572–577.CrossRefGoogle ScholarPubMed