Family study of fibromyalgia

Abstract

Objective. To assess for familial aggregation of fibromyalgia (FM) and measures of tenderness and pain, and for familial coaggregation of FM and major mood disorder (major depressive disorder or bipolar disorder).Methods. Probands meeting the American College of Rheumatology criteria for FM and control probands with rheumatoid arthritis (RA) and no lifetime diagnosis of FM were recruited from consecutive referrals to 2 community-based rheumatology practices. Probands were ages 40-55 years and had at least 1 firstdegree relative age 18 years or older who was available for interview and examination. All probands and interviewed relatives underwent a dolorimeter tender point examination and a structured clinical interview. Interviewed relatives were asked about first-degree relatives who were not available for interview, using a structured family interview. Logistic and linear regression models, adjusting for the correlation of observation within families, were applied to study the aggregation and coaggregation effects.Results. Information was collected for 533 relatives of 78 probands with FM and 272 relatives of 40 probands with RA. FM aggregated strongly in families: the odds ratio (OR) measuring the odds of FM in a relative of a proband with FM versus the odds of FM in a relative of a proband with RA was 8.5 (95% confidence interval [95% CI] 2.8-26, P ‫؍‬ 0.0002). The number of tender points was significantly higher, and the total myalgic score was significantly lower in the relatives of probands with FM compared with the relatives of probands with RA. FM coaggregated significantly with major mood disorder: the OR measuring the odds of major mood disorder in a relative of a proband with FM versus the odds of major mood disorder in a relative of a proband with RA was 1.8 (95% CI 1.1-2.9, P ‫؍‬ 0.013).Conclusion. FM and reduced pressure pain thresholds aggregate in families, and FM coaggregates with major mood disorder in families. These findings have important clinical and theoretical implications, including the possibility that genetic factors are involved in the etiology of FM and in pain sensitivity. In addition, mood disorders and FM may share some of these inherited factors.Fibromyalgia (FM) is a disorder of unknown etiology and is defined by the American College of Rheumatology (ACR) as widespread pain of at least 3 months duration in combination with tenderness at 11 or more of 18 specific tender point sites on the body (1). Other characteristic symptoms of FM include fatigue, sleep disturbance, and morning stiffness (1). It is not known whether FM aggregates in families. Three studies found an elevated prevalence of FM in first-degree relatives of probands with FM (2-4). In the first of those studies, 26 (50%) of 50 parents and siblings of 17 probands had FM (2). However, standard criteria for the diagnosis of FM were not used, and the number of relatives who chose not to participate was not reported. More recently, Buskila et al reported that 16 (28%) of the 58 children of 20 women with FM were diagnose...

Family factors, emotional functioning, and functional impairment in juvenile fibromyalgia syndrome

“…Gathering data from multiple sources is therefore highly desirable when assessing children and adolescents with chronic pain. The findings of the present study, which used an unusually precise matched control group design, confirmed the results of past research indicating that mood difficulties and pain sensitivity tend to cluster in families (8), and that parents of adolescents with JPFS have a higher likelihood of experiencing chronic pain themselves (12). Mothers of adolescents with JPFS in this study reported significantly greater depressive symptoms than mothers of comparison peers.…”

“…Items are rated on a 5-point Likert scale regarding the degree to which each symptom distressed the individual in the past week (0 ϭ not at all, 4 ϭ extremely). Scores on the anxiety and depression subscales were used in this study based upon past research indicating a higher prevalence of anxiety and mood symptoms in fibromyalgia patients and family members (8). The SCL-90-R has demonstrated adequate reliability (28) and has been previously used to assess distress in parents of children with chronic illness (29,30).…”

A twin study of posttraumatic stress disorder symptoms and chronic widespread pain

“…Similarly, studies of FM have demonstrated a familial or genetic influence. For example, a high prevalence of FM has been found repeatedly among offspring of mothers with FM, and relatives of people with FM have a lower tender point threshold than the general population (Arnold et al 2004;Buskila et al 1996). Another study showed that husbands of women with FM had a high prevalence of FM .…”

“…Additionally, both PTSD and FM are thought to be partially heritable. Family studies have shown that FM aggregates strongly in families (Arnold et al 2004;Buskila and Neumann 1997;Buskila et al 1996;Pellegrino et al 1989), but linkage studies have found either a weak linkage or none at all (Gursoy 2002;Yunus et al 1999). Investigations into the heritability of PTSD have shown that PTSD is related to family history of psychiatric illness (Davidson et al 1989;Koenen et al 2002;Koenen et al 2003).…”

A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis

“…Ratings of global change have been used in both intervention and methodological studies. [35][36][37][38] A single question was used post-intervention, which asked participants how they felt in terms of their general well-being and health compared with pre-intervention using a seven-point scale: very much worse, worse, somewhat worse, the same, somewhat better, better, or very much better.…”