Chronic widespread musculoskeletal pain with or without fibromyalgia: psychological distress in a representative community adult sample.

Objective: To estimate the severity of depression, anxiety, and other symptoms of psychological distress in a representative general population sample of fibromyalgia (FM) cases (FC) compared to pain controls (PC), and to identify strong correlates of depression and anxiety.

Methods: We compared the severity of depression, anxiety, and other symptoms of psychological distress between 2 representative community samples: (1) 74 confirmed FC, and (2) 48 adults with chronic widespread pain (PC) who did not meet the 1990 ACR criteria for FM. Psychological distress was measured using the Centre for Epidemiological Studies Depression (CES-D) Scale, the State-Trait Anxiety Inventory (STAI), and other measures of psychological distress from the literature. Using cutoff scores for CES-D and trait anxiety, we compared demographic and clinical characteristics in those above and below each cutoff score. Simple linear regression was performed to identify factors strongly and independently correlated with depression and trait anxiety.

Results: Compared to PC, FC were more symptomatic on virtually all measures of psychological distress. Similarly, individuals who scored above cutoff scores for depression and anxiety had more physical symptoms and had poorer function than those below. Depression and trait anxiety were highly correlated (r = 0.86). In a simple regression model, the best predictors for both depression and trait anxiety were the total number of symptoms and a physical disability score.

Conclusion: Depression and anxiety are common and frequently severe even among community cases of FM.