PSYCHIATRIC DIAGNOSES IN PATIENTS WITH FIBROMYALGIA ARE RELATED TO HEALTH CARE-SEEKING BEHAVIOR RATHER THAN TO ILLNESS

Objective. To compare the frequency of lifetime psychiatric disorders among 3 groups of subjects: patients with fibromyalgia syndrome (FMS) from a tertiary care setting, community residents with FMS who had not sought medical care for their FMS symptoms (''FMS nonpatients''), and healthy controls. Methods. We used the Computerized Diagnostic Interv iew Schedule to assess lifetime psychiatric diagnoses, as well as the Center for Epidemiological Studies Depression scale and the Trait Anxi ety Inventory to assess current psychological distress, among 64 patie nts with FMS, 28 FMS nonpatients, and 23 healthy individuals. Results. Patients with FMS, relative to FMS nonpatients and healthy controls, were characterized by a significantly greater number of lifetime psych iatric diagnoses (P = 0.002). Nonpatients did not differ from controls in psychiatric diagnoses. Patients also exhibited higher psychologica l distress levels than nonpatients, and nonpatients showed greater dis tress than controls. Differences in psychological distress between pat ients and nonpatients were eliminated after controlling for pain thres hold and fatigue ratings. Conclusion. Psychiatric disorders are not in trinsically related to the FMS syndrome. Instead, multiple lifetime ps ychiatric diagnoses may contribute to the decision to seek medical car e for FMS in tertiary care settings.