FIBROMYALGIA, DEPRESSION AND MYOFASCIAL TMD

描述(取自申请表)： 纤维肌痛(FMS)与抑郁症的共病 (MDD)引发了对两国关系走向的猜测。三 这里要检验的主要假设是：(L)FMS是 抑郁症；(2)FMS患者的MDD是FMS的反应；以及(3)FMS患者的MDD FMS患者中MDD的高发生率是一个研究的人工制品 寻求治疗的人。这项拟议的研究的第一个目的是支持一项研究，并驳斥 其他假设，通过进行一项家庭研究。社区妇女会议 FMS的标准(n=120)将分层，以便一半(n=60)具有 MDD终生病史。人口统计匹配的非FMS控制(n=120) 同样的抽样框架也将根据MDD状况进行分层。直接 精神科面谈和身体检查将与 先证者和他们所有有空的成年一级亲属。为了支持 第一个假设，家族性MDD发生率在FMS先证者中应该更高，甚至 在没有个人抑郁症病史的先证者中；为了支持第二种情况， 患有FMS和MDD的先证者应该有较低的家庭抑郁率，因为他们 抑郁症更有可能是对FMS的反应；为了支持最后一个家庭成员 MDD应在本身有MDD病史的先证者中升高，无论 FMS状态。第二个目标，由FMS和肌筋膜共病推动 颞下颌关节紊乱病(M/TMD)，是(1)M/TMD是否是区域性的 FMS的表现或(2)M/TMD合并FMS是否不同于 M/TMD表现为区域性疾病。为了实现这一目标，我们将首先 再次确认FMS是家族性的，利用收集的数据满足第一个 瞄准。其次，根据两个FMS，我们将从目标1开始重组小组 和M/TMD状态。家族性M/TMD在FMS和对照先证者中的破损率 先证者的M/TMD状态，将被检查。如果在家庭中发现M/TMD 对于FMS先证者，无论先证者M/TMD状态，这将支持 第一个假设。如果只有FMS先证者有家族性M/TMD先证者，而M/TMD先证者 不，这将支持第二个假设，并表明这两个 疾病是通过不同的致病过程引起的。

DESCRIPTION (taken from the application): The well-established comorbidity of fibromyalgia (FMS) and major depression (MDD) has motivated speculations about the direction of the relationship. Three principal hypotheses to be tested here are: (l)that FMS is a variant of depression; (2) that MDD in FMS sufferers is a reaction to FMS; and (3) that high rates of MDD in FMS patients are an artifact of studying treatment-seekers. The proposed study's first aim is to support one and refute other hypotheses, by conducting a family study. Community women meeting criteria for FMS (n= 120) will be stratified so that half (n=60) have a lifetime history of MDD. Demographically-matched non-FMS controls (n= 120) from the same sampling frame will also be stratified on MDD status. Direct psychiatric interviews and physical examinations will be conducted with probands and all their available adult first degree relatives. To support the first hypothesis, familial MDD rates should be elevated in FMS probands, even among probands with no personal depression histories; to support the second, probands with FMS and MDD should have low familial depression rates, as their depression should be more likely reactive to FMS; to support the last, familial MDD should be elevated in probands with MDD histories themselves, regardless of FMS status. A second aim, prompted by the comorbidity of FMS and myofascial temporomandibular disorder (M/TMD), is test (1) whether M/TMD is a regional manifestation of FMS or (2) whether M/TMD comorbid with FMS is different from M/TMD expressed as a regional disorder. To accomplish this aim, we will first reconfirm that FMS is familial, utilizing data gathered to satisfy the first aim. Second, we will reconstitute the groups from Aim 1, according to both FMS and M/TMD status. Rates of familial M/TMD in FMS and control probands, broken down by proband M/TMD status, will be examined. If M/TMD is found in the family of FMS probands, regardless of proband M/TMD status, this will support the first hypothesis. If only FMS probands have familial M/TMD but M/TMD probands do not, this will support the 2nd hypothesis and indicate that the two disorders are provoked through different pathogenic processes.