Sapon D. Anxiety and depressive disorders in chronic pain syndrome and fibromyalgia

Was examined 206 patients with anxiety and depressive disorders associated with chronic pain, 97 people with fibromyalgia and 109 people with dorsalgia and pain in the joints. Was treated 164 patients, randomized into groups of psychopharmatherapy and psychotherapy with assessment of effectiveness in 4 and 12 weeks. There has been a comprehensive assessment of mental status of patients, chronic pain characteristics and comorbid psychopathological disorders, neurophysiological parameters. Described in detail the structure and clinical manifestations of mental disorders. The share of persons with mental disorders accounted for more than 2/3, and in the persons with fibromyalgia prevailed anxiety disorders, and on dorsalgia - depressive disorders. Severity of depressive disorders was significantly positively correlated with the duration and severity of chronic pain; and anxiety disorders - with only the severity of pain. Has been identified susceptibility to somatization of anxiety in sensory, motor and autonomic components of the initial implementation in the musculoskeletal system. It was noted reduced quality of life with greater infestation mental health component in the fibromyalgia and physical health component at dorsalgia. There was a definite connection fibromyalgia impact and consequences on FIQR scale with a medical history, psychopathological and clinical characteristics of patients with anxiety and depressive disorders. Neurophysiological studies revealed changes in the amplitude and latency of P300 influenced by the degree of severity of chronic pain. For all patients with anxiety and depressive disorders associated with chronic pain was determined more effective psychopharmacotherapy in the short-term treatment, while in long-term treatment - psychotherapy. Patients with fibromyalgia were more sensitive to both therapies with more expressive regarding anxiety symptoms compared to symptoms of depression.