TOPLINE:

Globally, nearly 51% of patients with fibromyalgia had depression, and 47% experienced anxiety in a new meta-analysis. Additionally, there were trends for anxiety prevalence decreasing with age and depression prevalence increasing with age, but there were no significant differences by female-to-male ratio or continent.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis of 92 studies published between January 1996 and March 2024 and spanning more than 20 countries in order to evaluate the prevalence of anxiety or depression symptoms in patients with fibromyalgia.
• The final analyses included nearly 30,000 participants from 84 studies that reported on anxiety and/or depression.
• Prevalence was compared across numerous factors, including publication year, female-to-male ratio, study design, continent, and the following assessment tools: the Diagnostic and Statistical Manual of Mental Disorders (DSM), the Hospital Anxiety and Depression Scale (HADS), and the State-Trait Anxiety Inventory (STAI).

TAKEAWAY:

• The pooled prevalence rate was 46.6% for comorbid anxiety and 50.8% for comorbid depression, with substantial heterogeneity in reporting. Anxiety prevalence decreased with age, while depression prevalence increased with age, but neither trend was significant.
• Anxiety and depression prevalence did not vary significantly by female-to-male ratio, publication year, continent, or study design. The prevalence of anxiety ranged from 15% in Colombia to 84% in Egypt, while that of depression ranged from 9% in Finland to 93% in Kenya.
• The overall prevalence of anxiety varied by evaluation source (P = .003), with higher rates from self-reporting than from clinician diagnosis (P = .02) or interview-based assessment (P = .01). The prevalence of depression did not differ by source.
• Anxiety prevalence varied significantly by assessment tool (P = .02), with DSM-based measures showing lower rates than the HADS (P = .03) and STAI (P = .04). Depression prevalence also differed by tool (P = .02), with the HADS yielding higher rates than other instruments (P = .03).

IN PRACTICE:

“One in two patients with fibromyalgia suffers from depression or anxiety. Depression and anxiety not only exacerbate the experience of pain but also make it harder to manage symptoms of fibromyalgia, resulting in a challenging cycle of pain and mental health issues,” the investigators of the study wrote.

SOURCE:

The analysis was led by Maryam Jafari, School of Medicine, Anzali International Campus, Guilan University of Medical Sciences, Rasht, Iran. It was published online on September 16 in the Journal of Affective Disorders.

LIMITATIONS:

The research was limited by significant heterogeneity across included studies and potential reliability concerns with self-reported questionnaires. The diagnostic assessment of depression in fibromyalgia patients presented challenges because of overlap between somatic symptoms, such as chronic pain and fatigue. Additionally, geographic representation was uneven, potentially skewing the global estimates.

DISCLOSURES:

The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.