FIBROMYALGIA, DEPRESSION, AND ALCOHOLISM - A FAMILY HISTORY STUDY

Objective. Fibromyalgia (FM) syndrome may be part of an ''affective sp ectrum disorder.'' The diseases in this group have in common high rate s of major depression in first degree relatives (FDR) and a response t o antidepressant treatment. In this familial aggregation study, we tes ted the hypothesis that depression in patients with FM is related to a family history of depression or alcoholism in their FDR. Methods. To assess the relationship between FM and lifetime histories of depressio n (DEP) and alcoholism (ALC), personal and family histories of mood an d substance use disorders were obtained from 60 probands with FM. DEP and ALC among the probands were diagnosed using the Schedule for Affec tive Disorders and Schizophrenia, a standardized, structured psychiatr ic interview, and the Research Diagnostic Criteria (RDC). Family psych opathology in the FDR (parents, full siblings, children) was assessed using the Family History RDC. The odds ratio (OR) for DEP and/or ALC i n FDR of probands with a history of DEP versus those without DEP were calculated. Confidence intervals (CI) not including 1 were significant at p<0.05 (95% CI). Results. The odds of identifying FDR with DEP and /or ALC were significantly higher among probands with FM with a lifeti me history of DEP than among probands with FM who had no history of DE P (OR = 2.10, 95% CI = 1.23-3.57). This may be accounted for by the si gnificantly higher odds for ALC among the FDR of probands with both FM and DEP compared with the FDR of probands with FM but no history of d epression (OR = 2.30, 95% CI = 1.21-4.37). Although alcoholism was inc reased in the FDR of probands with FM with a history of depression, th e odds for DEP were nonsignificantly higher among these FDR (OR = 1.71 , 95% CI = 0.87-3.31). OR in the same range of magnitude were obtained when the data were analyzed by family unit, but these results were no t statistically significant. Conclusion. Our data suggest that the ten dency toward DEP in patients with FM may be a manifestation of a famil ial depressive spectrum disorder (alcoholism and/or depression in the family members), not simply a ''reactive'' depression secondary to the pain and other symptoms.