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Can mastalgia be another somatic symptom in fibromyalgia syndrome?

ABSTRACT: The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome.Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically.Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome.We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia.

SUBMITTER: Sen M

PROVIDER: S-EPMC4642489 | biostudies-other | 2015 Nov

REPOSITORIES: biostudies-other

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Can mastalgia be another somatic symptom in fibromyalgia syndrome?

Sen Meral M Kilic Murat Ozgur MO Cemeroglu Ozlem O Icen Duygu D

Clinics (Sao Paulo, Brazil) 20151101 11

<h4>Objective</h4>The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome.<h4>Methods</h4>Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to ...[more]

PMID: 26602519

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Project description:ObjectivesWe tested the ability of the VASFIQ, a seven-item scale composed of Fibromyalgia Impact Questionnaire (FIQ) visual analog scales (VASs), to quantify fibromyalgia global disease severity and identify fibromyalgia patients with significant symptoms of fatigue, poor sleep, depression or anxiety.MethodsSpearman rank correlations were used to compare global VASFIQ, FIQ and Patient Global Impression of Change (PGIC) scores and individual FIQ VAS scores with full-length, validated questionnaire scores for fatigue (Multidimensional Assessment of Fatigue-Global Fatigue Index [MAF-GFI]), poor sleep (Medical Outcomes Study Sleep Problems Index [SPI]) and depression and anxiety (Hospital Anxiety and Depression Scale [HADS]). Patient scores used in the analyses were derived from 2229 patients enrolled in three pregabalin fibromyalgia trials. Receiver operating characteristic analyses determined VASFIQ cutoff scores identifying patients with clinically significant symptom levels using full-length, validated symptom questionnaires to define cases.ResultsGlobal VASFIQ and FIQ scores correlated highly at baseline and study endpoints (ρ = 0.94 and 0.97, respectively; both p<0.0001). Change in global VASFIQ and FIQ scores correlated similarly to PGIC scores at study endpoints (ρ = 0.58 and 0.61, respectively; both p<0.0001). Individual FIQ VAS scores correlated with corresponding full-length symptom questionnaire scores at baseline and study endpoints (VASfatigue with MAF-GFI, ρ = 0.64 and 0.76; VASsleep with SPI, ρ = 0.50 and 0.67; VASdepression with HADS-D, ρ = 0.43 and 0.62; VASanxiety with HADS-A, ρ = 0.47 and 0.67, respectively; p <0.0001 for all). Patients with significant symptoms of fatigue were identified by VASfatigue >7.5, poor sleep by VASsleep >7.9, depression by VASdepression >5.8 and anxiety by VASanxiety >6.0. VASFIQ global scores ≥31.4 and ≥45.0 identified patients with moderate and severe global fibromyalgia symptoms, respectively.ConclusionsThe VASFIQ scale accurately quantifies global fibromyalgia severity and identifies patients with significant symptoms of fatigue, poor sleep, depression or anxiety with brevity, enabling rapid patient assessment and informing treatment decisions in busy clinics.

Project description:Objectives: Despite satisfactory effectiveness of treatment for somatic symptom disorders (SSD), treatment rates are low and treatment is usually initiated many years after first symptoms. In order to understand whether a lack of public mental health literacy might contribute to these poor treatment rates, we aimed to focus on two research questions: (1) What does the German public know and think about SSD? (2) Are knowledge and beliefs associated with socio-demographic factors and experiences with the disorder? Methods: Two vignettes with symptoms of a SSD were used in a national telephone survey in Germany (N = 1,004). Vignettes differed regarding main type of symptom (pain vs. fatigue) and existence of an earlier somatic disease (yes vs. no). Respondents were asked concerning knowledge and beliefs about causes, symptoms, and treatment using a standardized questionnaire. Results: 66% of the respondents agreed that a possible cause of the symptoms is a misinterpretation of body signals. About 1/3 recognized a mental health problem when confronted with the vignettes of cases with SSD. This rate was lower in case of a SSD with pain as the main symptom without a comorbid somatic disease (24.8%, 95%-CI: 21.1-28.6) compared to a case with fatigue as the main symptom and an earlier severe somatic disease (44.0%, 95%-CI: 39.6-48.3). Female respondents tended to have a more positive view on treatability and effectiveness of psychotherapy, while associations of knowledge and beliefs with education and age were inconsistent. Respondents who had contact with a person with SSD were more likely to think that psychotherapy is effective and that they know a lot about SSD compared to those who never had contact. Conclusions: While most of the German public seems to be well informed about causes of SSD as well as treatability and the effectiveness of psychotherapy, the majority has problems with interpreting symptoms and does not think they know a lot about symptoms like that. Increasing knowledge about SSD by education interventions may help to promote adequate help seeking.

Project description:BackgroundSensory disturbances in fibromyalgia extend beyond nociception. It has been proposed that imbalance in the mutual competition between painful input and non-painful sensory activity may, to a significant extent, account for the augmented subjective perception of pain. In this context, non-nociceptive somatosensory stimulation could arguably attenuate fibromyalgia symptoms by restoring the sensory balance. We specifically tested the effect of vibrotactile stimulation on symptom relief in fibromyalgia patients with a randomized, double-blind, sham-controlled, crossover clinical trial.MethodsSeventy-seven female patients were randomized and data from 63 valid cases were analyzed. Active intervention involved extensive body stimulation with gentle mechanical vibrations administered during 3 h at night for 3 weeks, and the placebo effect was controlled using identical instruments to simulate an alternative treatment option. The primary outcome measure combined pain, fatigue, and complaints of poor cognition.ResultsVibrotactile stimulation was significantly superior to sham in alleviating fibromyalgia symptoms globally. However, univariate analyses showed that the effect was not universal. Benefits were perceived on unpleasant somatic sensations such as generalized pain and fatigue, but not on poor cognition, anxiety, and depression. Vibrotactile stimulation was notably well tolerated and sleep quality significantly improved despite the fact that vibrations were administered at night.ConclusionsResults thus provide new evidence that non-nociceptive somatosensory stimulation may favorably act upon altered somatosensory balance in fibromyalgia. From a clinical perspective, both the degree of improvement and the easy application of our proposal would seem to support a potential role for vibrotactile stimulation in the symptomatic treatment of fibromyalgia.Trial registrationClinicalTrials.gov registration number NCT03227952 . Registered 24 July, 2017.

Project description:BackgroundCoping strategies and their efficacy vary greatly in patients suffering from fibromyalgia syndrome (FMS).ObjectiveWe aimed to identify somatic and psychosocial factors that might contribute to different coping strategies and resilience levels in FMS.Subjects and methodsStandardized questionnaires were used to assess coping, pain, and psychological variables in a cohort of 156 FMS patients. Quantitative real-time polymerase chain reaction (qRT-PCR) determined gene expression of selected cytokines in white blood cells of 136 FMS patients and 25 healthy controls. Data of skin innervation, functional and structural sensory profiles of peripheral nociceptive nerve fibers of a previous study were included into the statistics. An exploratory factor analysis was used to define variance explaining factors, which were then included into cluster analysis.Results54.9% of the variance was explained by four factors which we termed (1) affective load, (2) coping, (3) pain, and (4) pro-inflammatory cytokines (p < 0.05). Considering differences in the emerged factors, coping strategies, cytokine profiles, and disability levels, 118 FMS patients could be categorized into four clusters which we named "maladaptive", "adaptive", "vulnerable", and "resilient" (p < 0.05). The adaptive cluster had low scores in disability and in all symptom categories in contrast to the vulnerable cluster, which was characterized by high scores in catastrophizing and disability (p < 0.05). The resilient vs. the maladaptive cluster was characterized by better coping and a less pro-inflammatory cytokine pattern (p < 0.05).ConclusionOur data suggest that problem- and emotion-focused coping strategies and an anti-inflammatory cytokine pattern are associated with reduced disability and might promote resilience. Additional personal factors such as low anxiety scores, ability of acceptance, and persistence further favor a resilient phenotype. Individualized therapy should take these factors into account.

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Can mastalgia be another somatic symptom in fibromyalgia syndrome?

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Can mastalgia be another somatic symptom in fibromyalgia syndrome?

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