Somatized depression as a subgroup of fibromyalgia syndrome

An increase of depressive symptoms in fibromyalgia patients has been noted in a number of studies. The etiologic significance of this finding remains, however, controversial. We suggest that a subgroup of patients with this s ymptom combination may be pragmatically classified as suffering from somati zed depression. Clinical indicators such as a family history of depressive disorders, circadian disturbances, pronounced loss of appetite or libido, a nd chronic psychosocial stressors should be assessed and, if present, promp t the initiation of psychiatric evaluation and treatment including pharmaco - and psychotherapeutic modalities. Other psychiatric diseases arising in t he differential diagnosis of fibromyalgia are discussed.