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OBJECTIVE: Patients with chronic widespread pain (CWP) have been reported to have a greater prevalence of mental disorders and somatization than that found in the general population, but the true association between CWP and mental disorders is unknown. In this study, we investigated whether there is an increased prevalence of mental disorder in people with CWP from the general population. We also describe the psychiatric diagnoses associated with CWP. METHODS: In a population-based case-control study, 1,953 subjects (75% of a random sample of individuals age 18-65 years) completed a questionnaire that included a pain assessment and the 12-item General Health Questionnaire (GHQ-12). Of 710 subjects scoring >1 on the GHQ-12, 301 were assessed further using a structured psychiatric interview and detailed assessment of medical records to identify cases of mental disorder, in accordance with criteria of the 10th edition of the International Classification of Diseases. The association between CWP and mental disorder was modeled using logistic regression, adjusting for possible confounders including age, sex, and nonresponders. RESULTS: We estimated the overall population prevalence of mental illness to be 11.9%. The odds of having a mental disorder for subjects with versus those without CWP were 3.18 (95% confidence interval 1.97-5.11). Most subjects with mental disorders were diagnosed as having mood and anxiety disorders. Only 3 cases of somatoform disorders were identified, and all were associated with pain. CONCLUSION: This study, although unable to demonstrate a cause-and-effect relationship, showed that 16.9% of those with CWP were estimated to have a psychiatric diagnosis, suggesting that these disorders should be identified and treated.

Original publication

DOI

10.1002/1529-0131(200003)43:3<561::aid-anr12>3.0.co;2-o

Type

Journal article

Journal

Arthritis and rheumatism

Publication Date

03/2000

Volume

43

Pages

561 - 567

Addresses

University of Manchester, UK.

Keywords

Humans, Fibromyalgia, Pain, Chronic Disease, Pain Measurement, Questionnaires, Prevalence, Depression, Stress, Psychological, Mental Disorders, Anxiety Disorders, Somatoform Disorders, Adolescent, Adult, Aged, Middle Aged, Diagnosis-Related Groups, Female, Male