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Fibromyalgia linked to bipolar spectrum disorders
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Fibromyalgia is related to bipolar spectrum disorders, particularly the hypomania/overactivity component, according to study results.
Between May 2010 and May 2011, researchers conducted a study of 110 patients (mean age, 46.12 years; 92.7% women) with fibromyalgia who were attending a rheumatology clinic at a hospital in Milan, Italy.
Categorical and dimensional approaches were used for assessing bipolar disorders. A version of the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version, Mood Disorder module, modified to improve detection of bipolar spectrum disorders, was used. Researchers also used the Zurich criteria to comprise bipolar spectrum subtypes. The dimensional approach was based on the hypomania symptom checklist (HCL-32), “which adopts a dimensional perspective of the manic/hypomanic component of mood by including subsyndromal hypomania.”
Seventy percent of patients were diagnosed with bipolar spectrum disorder based on DSM-IV, while 86.3% of patients were diagnosed according to the Zurich classification. Demographic and clinical aspects did not differ between patients with a major (bipolar II disorder) or a minor bipolar spectrum disorder (subthreshold depression and hypomania).
Seventy-nine percent of patients with fibromyalgia scored 14 — the threshold for hypomania — or more on the HCL-32, which confirmed high estimates of the bipolar spectrum.
Researchers said the study may have been affected by referral bias because patients were drawn from a tertiary care facility, resulting in “an overestimation of the prevalence of mood disorders.”
The study showed “a higher-than-expected comorbidity between fibromyalgia and bipolar spectrum disorders among patients with fibromyalgia as compared to the general population,” the researchers concluded. “The rate found … is higher than the top prevalence rate of bipolar spectrum disorders reported in the literature from community studies.”
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