Advancing the screening of fibromyalgia in late-life depression: practical implications for psychiatric settings.
Advancing the screening of fibromyalgia in late-life depression: practical implications for psychiatric settings.
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推进晚年抑郁症纤维肌痛的筛查：对精神病学环境的实际影响。
DOI：
10.1017/s1041610215000666
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发表时间：
2015
影响因子：
7
通讯作者：
Karp,JordanF
中科院分区：
文献类型：
--
作者：
Jochum,JohnR;Begley,AmyE;Dew,MaryAmanda;Weiner,DebraK;Karp,JordanF
背景纤维肌痛（FM）在患有情绪障碍的老年人中很常见。然而，FM 的临床诊断具有挑战性，特别是在精神病学环境中。我们检查了 FM 的患病率以及三种简单的 FM 筛查方法的敏感性。方法使用横截面数据，我们根据美国风湿病学会 (ACR) 1990 年 FM 分类标准评估了三项测试：“您是否经常感觉浑身疼痛？”问题、疼痛图评分以及 Pope 和 Hudson (PH) 的 FM 采访。参与者是 185 名年龄≥ 60 岁的社区居民，患有抑郁症和慢性腰痛，在晚年心理健康诊所进行了评估。结果 185 名参与者中有 53 名 (29%) 符合 ACR 1990 FM 标准。与没有 FM 的组相比，FM 组对“浑身受伤？”的回答更多是“是”。问题和更高的疼痛图分数。为了达到至少 0.90 的敏感度，疼痛图的截止分数为 8。疼痛图的敏感度“浑身都痛？”问题和 PH 标准分别为 0.92 [95% CI 0.82–0.98]、0.91 [95% CI 0.79–0.97] 和 0.94 [95% CI 0.843–0.99]。 结论 患有抑郁症和慢性腰痛的老年人中近三分之一符合 ACR 1990 FM 标准。与 ACR 1990 FM 标准相比，三个简短的筛选测试显示出高灵敏度。在老年精神病学环境中实施一种简单的 FM 筛查可能会指导进一步诊断评估的需要。
BackgroundFibromyalgia (FM) is common in older adults suffering from mood disorders. However, clinical diagnosis of FM is challenging, particularly in psychiatric settings. We examined the prevalence of FM and the sensitivity of three simple screeners for FM.MethodsUsing cross-sectional data, we evaluated three tests against the American College of Rheumatology (ACR) 1990 Criteria for the Classification of FM: a “Do you often feel like you hurt all over?” question, a pain map score, and the Pope and Hudson (PH) interview for FM. Participants were 185 community-dwelling adults ≥ 60 years old with comorbid depression and chronic low back pain evaluated at a late-life mental health clinic.ResultsFifty three of 185 participants (29%) met the ACR 1990 FM criteria. Compared to those without FM, the FM group had more “yes” answers to the “hurt all over?” question and higher pain map scores. To reach a sensitivity of at least 0.90, the cut-off score for the pain map was 8. The sensitivity of the pain map, “hurt all over?” question, and PH criteria were 0.92 [95%CI 0.82–0.98], 0.91 [95%CI 0.79–0.97], and 0.94 [95%CI 0.843–0.99] respectively.ConclusionsNearly one in three older adults suffering from depression and chronic low back pain met ACR 1990 FM criteria. Three short screening tests showed high sensitivity when compared to the ACR 1990 FM criteria. Implementation of one of the simple screeners for FM in geriatric psychiatry settings may guide the need for further diagnostic evaluation.