Differences in depression, anxiety and stress disorders between fibromyalgia associated with rheumatoid arthritis and primary fibromyalgia

<p>Fibromyalgia (FM) was frequently observed in patients with rheumatoid arthritis<br> (RA). We aimed to evaluate the differences in psychiatric comorbidities and life adversities<br> between patients with Rheumatoid arthritis &thorn; FM (secondary fibromyalgia<br> [SFM]) and people with primary FM (PFM). In a cross‐sectional, observational study,<br> patients with PFM and SFM underwent a structured interview for the lifetime diagnosis<br> of major depression (MDD), panic disorder (PD) and post‐traumatic stress<br> disorder (PTSD) and were assessed for childhood/adulthood adversities and FMrelated<br> symptoms severity. Thirty patients withPFMand 40 withSFMwere recruited.<br> The univariate analysis showed that the lifetime rates of MDD were significantly<br> higher in PFM versus SFM (76.7 % and 40%, respectively, p &lt; 0.003), as well as the<br> rates of PD (50 % and 15%, respectively, p &lt; 0.003), whereas there was no difference<br> in PTSD rates. The rates of sexual abuse and physical neglect were significantly higher<br> in PFM patients versus SFM patients (p &lt; 0.005 and p &lt; 0.023). Life events occurring<br> before FM onset were different in PFM and SFM groups. In the logistic regression<br> model, lifetime PD and physical neglect remain independent risk factors for PFM.<br> PFM and SFM differ in psychiatric comorbidities and environmental adversities,<br> suggesting that common pathogenesis may develop through different pathways.</p>