Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
Objective: The aim of this study was to assess the relationship between the depressive disorder, sleep disorders and their influence on pain in patients with fibromyalgia. Material and methods: A population of 31 patients diagnosed of fibromyalgia according to the criteria of the American College of Rheumatology and 29 controls with similar demographic characteristics were studied. Both groups completed the sleep sub-scale of the Multiphasic Personality Inventory (MMPI) and the Becks Depression Inventory (BDI) and underwent an assessment of pain threshold with a hand-held algometer both in disease-defining points and in control points. Findings were processed using the SPSS V8 software. Means and dispersion measurements were estimated for both groups. The statistical significance of the differences found was estimated through parametric tests, given the normal distribution of the populations. Lineal regression and multiple regression adjusted for the continuous study variables were used to measure association. Linearity of determinations linked to time of evolution was estimated using the Levene test. Results: The most relevant results were the differences found in total sleep disorders (p < 0.001) and its sub-scales, with the exception of sleepwalking and cycle. Depressive symptomatology assessed using the BDI test showed differences between cases and controls (p < 0.001), confirming in the patients a linear growth of the measures associated to time of evolution. Pain Threshold was also significantly higher in cases versus controls (p < 0.001) at all time points examined. Adjusted multiple regression analysis of these variables suggested a synergic effect between pain, sleep disorders and BDI score, with an adjusted r2 close association between fibromyalgia and several symptoms that certainly affect the quality of life of patients. Discussion: Sleep-associated symptoms are considered the second in relevance in this syndrome. Sleep disorders and depression seem to accompany pain, further worsening the quality of life of these patients. It must be stressed, as the contribution of our study, that this symptomatology evolves with time, so we consider very important to perform an individual assessment of each symptom using specific tools since the beginning of the process.
Palabras clave : Depression; Fibromyalgia; Chronic pain.