Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2006

Open Access 01-12-2006 | Research article

Major depression, fibromyalgia and labour force participation: A population-based cross-sectional study

Authors: Aliya Kassam, Scott B Patten

Published in: BMC Musculoskeletal Disorders | Issue 1/2006

Login to get access

Abstract

Background

Previous studies have documented an elevated frequency of depressive symptoms and disorders in fibromyalgia, but have not examined the association between this comorbidity and occupational status. The purpose of this study was to describe these epidemiological associations using a national probability sample.

Methods

Data from iteration 1.1 of the Canadian Community Health Survey (CCHS) were used. The CCHS 1.1 was a large-scale national general health survey. The prevalence of major depression in subjects reporting that they had been diagnosed with fibromyalgia by a health professional was estimated, and then stratified by demographic variables. Logistic regression models predicting labour force participation were also examined.

Results

The annual prevalence of major depression was three times higher in subjects with fibromyalgia: 22.2% (95% CI 19.4 – 24.9), than in those without this condition: 7.2% (95% CI 7.0 – 7.4). The association persisted despite stratification for demographic variables. Logistic regression models predicting labour force participation indicated that both conditions had an independent (negative) effect on labour force participation.

Conclusion

Fibromyalgia and major depression commonly co-occur and may be related to each other at a pathophysiological level. However, each syndrome is independently and negatively associated with labour force participation. A strength of this study is that it was conducted in a large probability sample from the general population. The main limitations are its cross-sectional nature, and its reliance on self-reported diagnoses of fibromyalgia.
Literature
1.
go back to reference Nampiaparampil DE, Shmerling RH: A review of fibromyalgia. Am J Man Care. 2004, 10: 794-800. Nampiaparampil DE, Shmerling RH: A review of fibromyalgia. Am J Man Care. 2004, 10: 794-800.
2.
go back to reference Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L: The prevalence and characteristics of fibromyalgia in the general population. Arth Rheum. 1995, 38: 19-28.CrossRef Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L: The prevalence and characteristics of fibromyalgia in the general population. Arth Rheum. 1995, 38: 19-28.CrossRef
3.
go back to reference Prescott E, Kjoller M, Jacobsen S, Bulow PM, Danneskiold-Samsoe B, Kamper-Jorgensen F: Fibromyalgia in the adult Danish population: I. A prevalence study. Scand J Rheumatol. 1993, 22: 233-237.CrossRefPubMed Prescott E, Kjoller M, Jacobsen S, Bulow PM, Danneskiold-Samsoe B, Kamper-Jorgensen F: Fibromyalgia in the adult Danish population: I. A prevalence study. Scand J Rheumatol. 1993, 22: 233-237.CrossRefPubMed
4.
go back to reference Makela M, Heliovaara M: Prevalence of primary fibromyalgia in the Finnish population. Br Med J. 1991, 303: 216-219.CrossRef Makela M, Heliovaara M: Prevalence of primary fibromyalgia in the Finnish population. Br Med J. 1991, 303: 216-219.CrossRef
5.
go back to reference White KP, Speechley M, Harth M, Ostbye T: The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. Journal of Rheumatology. 1999, 26: 1570-1576.PubMed White KP, Speechley M, Harth M, Ostbye T: The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. Journal of Rheumatology. 1999, 26: 1570-1576.PubMed
6.
go back to reference Wells KB, Golding JM, Burnam MA: Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am J Psychiatry. 1988, 145: 976-981.CrossRefPubMed Wells KB, Golding JM, Burnam MA: Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am J Psychiatry. 1988, 145: 976-981.CrossRefPubMed
7.
go back to reference Moldin SO, Scheftner WA, Rice JP, Nelson E, Knesevich MA, Akiskal H: Association between major depressive disorder and physical illness. Psychol Med. 1993, 23: 755-761.CrossRefPubMed Moldin SO, Scheftner WA, Rice JP, Nelson E, Knesevich MA, Akiskal H: Association between major depressive disorder and physical illness. Psychol Med. 1993, 23: 755-761.CrossRefPubMed
8.
go back to reference Patten SB: Long-term medical conditions and major depression in a Canadian population survey at waves 1 and 2. J Affect Disord. 2001, 63: 35-41. 10.1016/S0165-0327(00)00186-5.CrossRefPubMed Patten SB: Long-term medical conditions and major depression in a Canadian population survey at waves 1 and 2. J Affect Disord. 2001, 63: 35-41. 10.1016/S0165-0327(00)00186-5.CrossRefPubMed
9.
go back to reference Benjamin S, Morris S, McBeth J, MacFarlane GJ, Silman AJ: The association between chronic widespread pain and mental disorder. A population-based study. Arth Rheum. 2000, 43: 561-567. 10.1002/1529-0131(200003)43:3<561::AID-ANR12>3.0.CO;2-O.CrossRef Benjamin S, Morris S, McBeth J, MacFarlane GJ, Silman AJ: The association between chronic widespread pain and mental disorder. A population-based study. Arth Rheum. 2000, 43: 561-567. 10.1002/1529-0131(200003)43:3<561::AID-ANR12>3.0.CO;2-O.CrossRef
10.
go back to reference Hudson JI, Arnold LM, Keck PE, Auchenback MB, Pope HG: Family study of fibromyalgia and affective spectrum disorder. Biol Psychiatry. 2004, 56: 884-891. 10.1016/j.biopsych.2004.08.009.CrossRefPubMed Hudson JI, Arnold LM, Keck PE, Auchenback MB, Pope HG: Family study of fibromyalgia and affective spectrum disorder. Biol Psychiatry. 2004, 56: 884-891. 10.1016/j.biopsych.2004.08.009.CrossRefPubMed
11.
go back to reference Sayar K, Gulec H, Topbas M: Alexithymia and anger in patients with fibromyalgia. Clin Rheumatol. 2004, 23: 441-448. 10.1007/s10067-004-0918-3.CrossRefPubMed Sayar K, Gulec H, Topbas M: Alexithymia and anger in patients with fibromyalgia. Clin Rheumatol. 2004, 23: 441-448. 10.1007/s10067-004-0918-3.CrossRefPubMed
12.
go back to reference Kivimäki M, Leino-Arjas P, Virtanen M, Elovainio M, Keltikangas-Järvinen L, Puttonen S, Vartia M, Burnner E, Vahtera J: Work stress and incidence of newly diagnosed fibromyalgia. Prospective cohort study. J Psychosom Res. 2004, 57: 417-422. 10.1016/j.jpsychores.2003.10.013.PubMed Kivimäki M, Leino-Arjas P, Virtanen M, Elovainio M, Keltikangas-Järvinen L, Puttonen S, Vartia M, Burnner E, Vahtera J: Work stress and incidence of newly diagnosed fibromyalgia. Prospective cohort study. J Psychosom Res. 2004, 57: 417-422. 10.1016/j.jpsychores.2003.10.013.PubMed
13.
go back to reference Goldberg RT, Pachas WN, Keith D: Relationship between traumatic events in childhood and chronic pain. Disabil Rehabil. 1999, 21: 23-30. 10.1080/096382899298061.CrossRefPubMed Goldberg RT, Pachas WN, Keith D: Relationship between traumatic events in childhood and chronic pain. Disabil Rehabil. 1999, 21: 23-30. 10.1080/096382899298061.CrossRefPubMed
14.
go back to reference Arnold LM, Hess EV, Hudson JI, Welge JA, Berno SE, Keck PE: A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia. Am J Med. 2002, 112: 191-197. 10.1016/S0002-9343(01)01089-0.CrossRefPubMed Arnold LM, Hess EV, Hudson JI, Welge JA, Berno SE, Keck PE: A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia. Am J Med. 2002, 112: 191-197. 10.1016/S0002-9343(01)01089-0.CrossRefPubMed
15.
go back to reference Montoya P, Larbig W, Braun C, Preissl H, Birbaumer N: Influence of social support and emotional context on pain processing and magnetic brain responses in fibromyalgia. Arth Rheum. 2004, 12: 4035-4044. 10.1002/art.20660.CrossRef Montoya P, Larbig W, Braun C, Preissl H, Birbaumer N: Influence of social support and emotional context on pain processing and magnetic brain responses in fibromyalgia. Arth Rheum. 2004, 12: 4035-4044. 10.1002/art.20660.CrossRef
16.
go back to reference Ercolani M, Trombini G, Chattat R, Cervini C, Piergiocomi G, Salaffi F, Zeni S, Marcolongo R: Fibromyalgic syndrome: depression and abnormal illness behavior. Multicenter investigation. Psychother Psychosom. 1994, 61: 178-186.CrossRefPubMed Ercolani M, Trombini G, Chattat R, Cervini C, Piergiocomi G, Salaffi F, Zeni S, Marcolongo R: Fibromyalgic syndrome: depression and abnormal illness behavior. Multicenter investigation. Psychother Psychosom. 1994, 61: 178-186.CrossRefPubMed
17.
go back to reference Alfici S, Sigal M, Landau M: Primary fibromyalgia syndrome - a variant of depressive disorder?. Psychother Psychosom. 1989, 51: 156-161.CrossRefPubMed Alfici S, Sigal M, Landau M: Primary fibromyalgia syndrome - a variant of depressive disorder?. Psychother Psychosom. 1989, 51: 156-161.CrossRefPubMed
18.
go back to reference Hudson JI, Goldenberg DL, Pope HG, Keck PE, Schlesinger L: Comorbidity of fibromyalgia with medical and psychiatric disorders. Am J Med. 1992, 92: 363-367. 10.1016/0002-9343(92)90265-D.CrossRefPubMed Hudson JI, Goldenberg DL, Pope HG, Keck PE, Schlesinger L: Comorbidity of fibromyalgia with medical and psychiatric disorders. Am J Med. 1992, 92: 363-367. 10.1016/0002-9343(92)90265-D.CrossRefPubMed
19.
go back to reference Van Houdenhove B, Egle UT: Fibromyalgia: a Stress Disorder? Piecing the biopsychosocial puzzle together. Psychother Psychosom. 2004, 73: 267-275. 10.1159/000078843.CrossRefPubMed Van Houdenhove B, Egle UT: Fibromyalgia: a Stress Disorder? Piecing the biopsychosocial puzzle together. Psychother Psychosom. 2004, 73: 267-275. 10.1159/000078843.CrossRefPubMed
20.
go back to reference Aaron LA, Bradley LA, Alarcón GS, Alexander RW, Triana-Alexander M, Martin MY, Alberts KR: Psychiatric diagnoses in patients with fibromyalgia are related to health care-seeking behavior rather than to illness. Arth Rheum. 1996, 39: 436-445.CrossRef Aaron LA, Bradley LA, Alarcón GS, Alexander RW, Triana-Alexander M, Martin MY, Alberts KR: Psychiatric diagnoses in patients with fibromyalgia are related to health care-seeking behavior rather than to illness. Arth Rheum. 1996, 39: 436-445.CrossRef
21.
go back to reference Robinson RL, Birnbaum HG, Morley MA, Sisitsky T, Greenberg PE, Wolfe F: Depression and fibromyalgia: treatment and cost when diagnosed separately or concurrently. J Rheumatol. 2004, 31: 1621-1629.PubMed Robinson RL, Birnbaum HG, Morley MA, Sisitsky T, Greenberg PE, Wolfe F: Depression and fibromyalgia: treatment and cost when diagnosed separately or concurrently. J Rheumatol. 2004, 31: 1621-1629.PubMed
22.
go back to reference Canada S: Canadian Community Health Survey (CCHS) Cycle 1.1. Derived Variables (DV) Specifications. [http://www.statcan.ca/english/sdds/document/3226_D5_T9_V2_E.pdf]. 2002, Ottawa, Canada Canada S: Canadian Community Health Survey (CCHS) Cycle 1.1. Derived Variables (DV) Specifications. [http://​www.​statcan.​ca/​english/​sdds/​document/​3226_​D5_​T9_​V2_​E.​pdf]. 2002, Ottawa, Canada
23.
go back to reference Bair MJ, Robinson RL, Katon W, Kroenke K: Depression and pain comorbidity. A literature revew. Arch Intern Med. 2003, 163: 2433-2445. 10.1001/archinte.163.20.2433.CrossRefPubMed Bair MJ, Robinson RL, Katon W, Kroenke K: Depression and pain comorbidity. A literature revew. Arch Intern Med. 2003, 163: 2433-2445. 10.1001/archinte.163.20.2433.CrossRefPubMed
24.
go back to reference Williams DA: Psychological and behavioural therapies in fibromyalgia and related syndromes. Best Pract Res Clin Rheum. 2003, 17: 649-665. 10.1016/S1521-6942(03)00034-2.CrossRef Williams DA: Psychological and behavioural therapies in fibromyalgia and related syndromes. Best Pract Res Clin Rheum. 2003, 17: 649-665. 10.1016/S1521-6942(03)00034-2.CrossRef
Metadata
Title
Major depression, fibromyalgia and labour force participation: A population-based cross-sectional study
Authors
Aliya Kassam
Scott B Patten
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2006
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-7-4

Other articles of this Issue 1/2006

BMC Musculoskeletal Disorders 1/2006 Go to the issue