Differences in depression, anxiety and stress disorders between fibromyalgia associated with rheumatoid arthritis and primary fibromyalgia

Fibromyalgia (FM) was frequently observed in patients with rheumatoid arthritis
(RA). We aimed to evaluate the differences in psychiatric comorbidities and life adversities
between patients with Rheumatoid arthritis þ FM (secondary fibromyalgia
[SFM]) and people with primary FM (PFM). In a cross‐sectional, observational study,
patients with PFM and SFM underwent a structured interview for the lifetime diagnosis
of major depression (MDD), panic disorder (PD) and post‐traumatic stress
disorder (PTSD) and were assessed for childhood/adulthood adversities and FMrelated
symptoms severity. Thirty patients withPFMand 40 withSFMwere recruited.
The univariate analysis showed that the lifetime rates of MDD were significantly
higher in PFM versus SFM (76.7 % and 40%, respectively, p < 0.003), as well as the
rates of PD (50 % and 15%, respectively, p < 0.003), whereas there was no difference
in PTSD rates. The rates of sexual abuse and physical neglect were significantly higher
in PFM patients versus SFM patients (p < 0.005 and p < 0.023). Life events occurring
before FM onset were different in PFM and SFM groups. In the logistic regression
model, lifetime PD and physical neglect remain independent risk factors for PFM.
PFM and SFM differ in psychiatric comorbidities and environmental adversities,
suggesting that common pathogenesis may develop through different pathways.