Fibromyalgia, mood disorders cluster in families

[Guest guest]

Rheumawire

Mar 26, 2004

Fibromyalgia, mood disorders cluster in families

Cincinnati, OH - Fibromyalgia (FM) aggregates strongly in families and

also appears to be strongly associated with familial occurrence of major

mood disorders such as major depression or bipolar disorder, Dr Lesley M

Arnold (University of Cincinnati College of Medicine, OH) reports in the

March 2004 issue of Arthritis & Rheumatism [1]. The study also found an

unexpectedly high rate of bipolar disorders (11.5%) in patients with FM,

suggesting that screening for these problems should be added to

screening for depression in work-ups of suspected fibromyalgia cases.

" The findings suggest that genetic factors might be involved in the

etiology of FM and pain sensitivity and that mood disorders may share

some of these inherited factors, " Arnold tells rheumawire.

This study, which was supported by the National Institute of Arthritis

and Musculoskeletal and Skin Diseases, was designed to determine whether

FM aggregates in families, whether the relatives of FM patients are

themselves likely to have increased levels of tenderness and pain, and

whether FM coaggregates with major mood disorders in families.

The researchers recruited 78 patients with FM and interviewed 146 of

their relatives as study subjects. As a sort of " active comparator, " the

study also enrolled 40 subjects with RA and 72 of their relatives.

Subjects were assessed using American College of Rheumatology criteria

for FM and RA, Diagnostic and Statistical Manual of Mental Disorders,

4th ed (DSM-IV) criteria for mental disorders, digital tender-point

examination, dolorimeter tender-point examination, and self-reports of

pain severity.

" The main findings are that FM aggregates strongly in families. The

estimated odds of FM in a relative of a proband with FM were 8.5 times

the odds of FM in a relative of a proband with RA. FM coaggregates with

major mood disorder in families, and relatives of probands with FM (not

RA) displayed higher levels of tendernessincreased tender points and

decreased myalgic scorethan relatives of probands with RA, " Arnold says.

The prevalence of FM was 6.4% among all relatives of probands with FM vs

1.1% among all relatives of probands with RA (odds ratio 8.5, p=0.0009).

The aggregation of FM in families was independent of the coaggregation

of FM with major mood disorder.

Relatives of probands with FM had a 32.1% lifetime prevalence of major

mood disorders vs a 19.1% lifetime prevalence in relatives of probands

with RA (OR 1.8, p=0.013).

Both tender-point count and total myalgic scores on dolorimetry were

strongly associated with FM in families, and this association was

independent of the presence of FM or major mood disorder. The

researchers conclude that this " supports the validity of the phenomenon

of lowered pressure pain thresholds in FM and suggests that inherited

factors may be involved in pain sensitivity. " However, an investigator

who was not blinded to the proband diagnosis performed the dolorimeter

examinations.

The presence of major mood disorders was strikingly different in the

probands with FM and with RA and was also higher in FM families vs RA

families (1.3% vs 0.4%).

" The presence of bipolar disorder in FM families was interesting and

suggests that we should be screening patients carefully for this

disorder as well as major depression when planning treatment, " Arnold

says.

The investigators conclude that FM and reduced pressure pain thresholds

aggregate in families and that FM coaggregates with major mood disorders

in families. " The coaggregation findings suggest that FM shares some

familial factor or set of factors with mood disorders, but that it also

has a factor or factors that are independent of mood disorders, " they

write. This argues for inclusion of mood symptoms in future phenotyping

studies in fibromyalgia, and Arnold tells rheumawire that such studies

are under way.

Janis

Source

1. Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia.

Arthritis Rheum 2004 Mar; 50(3):944-52.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[Guest guest]

Dear ,

Thank you for this informative article. This premise certainly holds true in my

family. My mother,

grandmother, brother are all bi-polar. Myself, mother, sister, and cousins are

diagnosed with FM.

There are other disorders in my family that are caused by the lack of certain

brain chemicals

which does indicate a familial association. With the brain being one of the most

unknown frontiers

in medicine, I do not think that the answers will be forthcoming in my lifetime.

I certainly hope;

for future generations in my family, that research will provide answers. Iris

--- <Matsumura_Clan@...> wrote:

> Rheumawire

> Mar 26, 2004

>

> Fibromyalgia, mood disorders cluster in families

>

> Cincinnati, OH - Fibromyalgia (FM) aggregates strongly in families and

> also appears to be strongly associated with familial occurrence of major

> mood disorders such as major depression or bipolar disorder, Dr Lesley M

> Arnold (University of Cincinnati College of Medicine, OH) reports in the

> March 2004 issue of Arthritis & Rheumatism [1]. The study also found an

> unexpectedly high rate of bipolar disorders (11.5%) in patients with FM,

> suggesting that screening for these problems should be added to

> screening for depression in work-ups of suspected fibromyalgia cases.

>

> " The findings suggest that genetic factors might be involved in the

> etiology of FM and pain sensitivity and that mood disorders may share

> some of these inherited factors, " Arnold tells rheumawire.

>

> This study, which was supported by the National Institute of Arthritis

> and Musculoskeletal and Skin Diseases, was designed to determine whether

> FM aggregates in families, whether the relatives of FM patients are

> themselves likely to have increased levels of tenderness and pain, and

> whether FM coaggregates with major mood disorders in families.

>

> The researchers recruited 78 patients with FM and interviewed 146 of

> their relatives as study subjects. As a sort of " active comparator, " the

> study also enrolled 40 subjects with RA and 72 of their relatives.

> Subjects were assessed using American College of Rheumatology criteria

> for FM and RA, Diagnostic and Statistical Manual of Mental Disorders,

> 4th ed (DSM-IV) criteria for mental disorders, digital tender-point

> examination, dolorimeter tender-point examination, and self-reports of

> pain severity.

>

> " The main findings are that FM aggregates strongly in families. The

> estimated odds of FM in a relative of a proband with FM were 8.5 times

> the odds of FM in a relative of a proband with RA. FM coaggregates with

> major mood disorder in families, and relatives of probands with FM (not

> RA) displayed higher levels of tendernessincreased tender points and

> decreased myalgic scorethan relatives of probands with RA, " Arnold says.

>

> The prevalence of FM was 6.4% among all relatives of probands with FM vs

> 1.1% among all relatives of probands with RA (odds ratio 8.5, p=0.0009).

> The aggregation of FM in families was independent of the coaggregation

> of FM with major mood disorder.

>

> Relatives of probands with FM had a 32.1% lifetime prevalence of major

> mood disorders vs a 19.1% lifetime prevalence in relatives of probands

> with RA (OR 1.8, p=0.013).

>

> Both tender-point count and total myalgic scores on dolorimetry were

> strongly associated with FM in families, and this association was

> independent of the presence of FM or major mood disorder. The

> researchers conclude that this " supports the validity of the phenomenon

> of lowered pressure pain thresholds in FM and suggests that inherited

> factors may be involved in pain sensitivity. " However, an investigator

> who was not blinded to the proband diagnosis performed the dolorimeter

> examinations.

>

> The presence of major mood disorders was strikingly different in the

> probands with FM and with RA and was also higher in FM families vs RA

> families (1.3% vs 0.4%).

>

> " The presence of bipolar disorder in FM families was interesting and

> suggests that we should be screening patients carefully for this

> disorder as well as major depression when planning treatment, " Arnold

> says.

>

> The investigators conclude that FM and reduced pressure pain thresholds

> aggregate in families and that FM coaggregates with major mood disorders

> in families. " The coaggregation findings suggest that FM shares some

> familial factor or set of factors with mood disorders, but that it also

> has a factor or factors that are independent of mood disorders, " they

> write. This argues for inclusion of mood symptoms in future phenotyping

> studies in fibromyalgia, and Arnold tells rheumawire that such studies

> are under way.

>

>

> Janis

>

> Source

>

> 1. Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia.

> Arthritis Rheum 2004 Mar; 50(3):944-52.

>

>

>

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

>

>

>

[Guest guest]

Hmmmm. Would this imply that Depression=FM? I am the first in my

family to have FM and the first to be diagnosed for Depression (over

20 years of it now). Thank you- D.

In , Iris Nosker <inosker@y...> wrote:

> Dear ,

>

> Thank you for this informative article. This premise certainly

holds true in my family. My mother,

> grandmother, brother are all bi-polar. Myself, mother, sister, and

cousins are diagnosed with FM.

> There are other disorders in my family that are caused by the lack

of certain brain chemicals

> which does indicate a familial association. With the brain being

one of the most unknown frontiers

> in medicine, I do not think that the answers will be forthcoming

in my lifetime. I certainly hope;

> for future generations in my family, that research will provide

answers. Iris

>

> --- <Matsumura_Clan@m...> wrote:

> > Rheumawire

> > Mar 26, 2004

> >

> > Fibromyalgia, mood disorders cluster in families

> >

> > Cincinnati, OH - Fibromyalgia (FM) aggregates strongly in

families and

> > also appears to be strongly associated with familial occurrence

of major

> > mood disorders such as major depression or bipolar disorder, Dr

Lesley M

> > Arnold (University of Cincinnati College of Medicine, OH)

reports in the

> > March 2004 issue of Arthritis & Rheumatism [1]. The study also

found an

> > unexpectedly high rate of bipolar disorders (11.5%) in patients

with FM,

> > suggesting that screening for these problems should be added to

> > screening for depression in work-ups of suspected fibromyalgia

cases.

> >

> > " The findings suggest that genetic factors might be involved in

the

> > etiology of FM and pain sensitivity and that mood disorders may

share

> > some of these inherited factors, " Arnold tells rheumawire.

> >

> > This study, which was supported by the National Institute of

Arthritis

> > and Musculoskeletal and Skin Diseases, was designed to determine

whether

> > FM aggregates in families, whether the relatives of FM patients

are

> > themselves likely to have increased levels of tenderness and

pain, and

> > whether FM coaggregates with major mood disorders in families.

> >

> > The researchers recruited 78 patients with FM and interviewed

146 of

> > their relatives as study subjects. As a sort of " active

comparator, " the

> > study also enrolled 40 subjects with RA and 72 of their

relatives.

> > Subjects were assessed using American College of Rheumatology

criteria

> > for FM and RA, Diagnostic and Statistical Manual of Mental

Disorders,

> > 4th ed (DSM-IV) criteria for mental disorders, digital tender-

point

> > examination, dolorimeter tender-point examination, and self-

reports of

> > pain severity.

> >

> > " The main findings are that FM aggregates strongly in families.

The

> > estimated odds of FM in a relative of a proband with FM were 8.5

times

> > the odds of FM in a relative of a proband with RA. FM

coaggregates with

> > major mood disorder in families, and relatives of probands with

FM (not

> > RA) displayed higher levels of tendernessincreased tender points

and

> > decreased myalgic scorethan relatives of probands with RA, "

Arnold says.

> >

> > The prevalence of FM was 6.4% among all relatives of probands

with FM vs

> > 1.1% among all relatives of probands with RA (odds ratio 8.5,

p=0.0009).

> > The aggregation of FM in families was independent of the

coaggregation

> > of FM with major mood disorder.

> >

> > Relatives of probands with FM had a 32.1% lifetime prevalence of

major

> > mood disorders vs a 19.1% lifetime prevalence in relatives of

probands

> > with RA (OR 1.8, p=0.013).

> >

> > Both tender-point count and total myalgic scores on dolorimetry

were

> > strongly associated with FM in families, and this association was

> > independent of the presence of FM or major mood disorder. The

> > researchers conclude that this " supports the validity of the

phenomenon

> > of lowered pressure pain thresholds in FM and suggests that

inherited

> > factors may be involved in pain sensitivity. " However, an

investigator

> > who was not blinded to the proband diagnosis performed the

dolorimeter

> > examinations.

> >

> > The presence of major mood disorders was strikingly different in

the

> > probands with FM and with RA and was also higher in FM families

vs RA

> > families (1.3% vs 0.4%).

> >

> > " The presence of bipolar disorder in FM families was interesting

and

> > suggests that we should be screening patients carefully for this

> > disorder as well as major depression when planning treatment, "

Arnold

> > says.

> >

> > The investigators conclude that FM and reduced pressure pain

thresholds

> > aggregate in families and that FM coaggregates with major mood

disorders

> > in families. " The coaggregation findings suggest that FM shares

some

> > familial factor or set of factors with mood disorders, but that

it also

> > has a factor or factors that are independent of mood disorders, "

they

> > write. This argues for inclusion of mood symptoms in future

phenotyping

> > studies in fibromyalgia, and Arnold tells rheumawire that such

studies

> > are under way.

> >

> >

> > Janis

> >

> > Source

> >

> > 1. Arnold LM, Hudson JI, Hess EV, et al. Family study of

fibromyalgia.

> > Arthritis Rheum 2004 Mar; 50(3):944-52.

> >

> >

> >

> >

> > I'll tell you where to go!

> >

> > Mayo Clinic in Rochester

> > http://www.mayoclinic.org/rochester

> >

> > s Hopkins Medicine

> > http://www.hopkinsmedicine.org

> >

> >

> >

> >

[Guest guest]

,

Depression is associated with FM but not everyone with FM suffers from

depression.

There are many causes of depression, just pain itself contributes. The

relationship

between pain and depression is complex. No one really knows what causes

depression.

The dominant theory is that it is a result of low levels of

neurotransmitters in the brain.

Neurotransmitters are messenger chemicals that carry signals from one nerve

cell to the next.

Stress, genetics, medicines and many other things can contribute to

depression.

a

> Hmmmm. Would this imply that Depression=FM? I am the first in my

> family to have FM and the first to be diagnosed for Depression (over

> 20 years of it now). Thank you- D.