Fibromyalgia in Egyptian Rheumatoid Arthritis Patients and patients with Depression

Document Type : Original Article

Authors

1 Department of Internal Medicine, Al-Azhar University; Egypt

2 Departments of Psychiatric Medicine, Al-Azhar University; Egypt

Abstract

Background: Fibromyalgia (FM) is a chronic musculoskeletal disorder resulting in chronic widespread pain.
Although it is currently believed to be the result of a central nervous system malfunction that increases pain transmission
and perception. Patients with fibromyalgia frequently experience psychiatric problems. Objectives: Is to estimate the
presence of fibromyalgia among Egyptian patients with rheumatoid arthritis (RA) and those with chronic depression.
Patients and methods: This study was done on 277 patients; 176 patients with rheumatoid arthritis (group I), and 101
patients with chronic depression (group II). The patients were selected from Al-Zahraa University Hospital, Al-Azhar
University. All patients were subjected to thorough clinical examination, laboratory investigation, calculation of disease
activity score, modified Beck scale for depression. Results: Among RA patients FM diagnosis was established in 21.02%
patients and 20.45% were females. Their mean age; 48.43 (±6.85) years that was significantly higher than RA patients
only (29.48±8.59) years. Among (group II) patients, FM diagnosis was established in 40 (39.60%) female patients and
3(2.97%) male patients. Our results showed that depressive symptoms were more common in RA patients with
fibromyalgia. DAS28 score was significantly higher in RA patients with FM mainly due to subjective component (number
of tender joints and patient global assessment). Conclusion: Fibromyalgia may coexist with autoimmune inflammatory
disorder like RA, commoner in older age, females and it worsens the disease activity. However, it is more common in
patients with chronic depression.

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