Management of Fibromyalgia and Comorbid Psychiatric Disorders

According to the American College of Rheumatology, fibromyalgia is
widespread pain of at least 3 months’ duration in combination with pain at 11
or more of 18 specific tender point sites on the body. Many individuals with
fibromyalgia also have comorbid psychiatric disorders, which can present
diagnostic dilemmas and require additional treatment considerations to
optimize patient outcomes. Fibromyalgia has been found to be strongly
associated with depressive and anxiety symptoms, a personal or family history
of depression, and accompanying antidepressant treatment. Psychiatric
comorbidities negatively impact the severity and course of fibromyalgia.
Pharmacotherapy can be employed to control fibromyalgia and comorbid mood and
anxiety disorders. Additionally, nonpharmacologic therapies for fibromyalgia
and comorbid psychiatric disorders include cognitive-behavioral therapy and
aerobic exercise. The efficacy of pharmacologic and nonpharmacologic
treatments is examined in this article, as well as the diagnostic difficulties
that comorbid disorders present. ‘ ‹