DSM-5 psychiatric disorders and DCPR syndromes and their effect on functional impairment in patients with fibromyalgia.

OBJECTIVE

This study investigated the effects of concurrent psychiatric disorders and psychosomatic syndromes on the functional impairment of patients with fibromyalgia.

METHODS

The study included two hundred patients diagnosed with fibromyalgia and treated at the Karadeniz Technical University Medical Faculty Physical Medicine and Rehabilitation Department. All patients were evaluated using a sociodemographic data form, the Fibromyalgia Impact Questionnaire (FIQ), Symptom Checklist-90 Revised (SCL-90R), Diagnostic Criteria for Psychosomatic Research (DCPR), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

RESULTS

Somatic Symptom Disorder (SSD) diagnostic criteria according to DSM-5 were met by 27.5 % of the patients, and illness anxiety disorder (IAD) criteria by 3 %. According to DCPR, 26 % of the participants were diagnosed with persistent somatization, 16 % with disease phobia, 3.5 % with health anxiety, and 17.5 % with thanatophobia. Diagnoses of both SSD and persistent somatization were associated with an increase in SCL-90-R somatization symptom severity and FIQ scores. At the same time, no significant relationship was determined between these diagnoses and anxiety, obsessive-compulsive, or depression symptom severity. Multivariate logistic regression analysis revealed that DCPR persistent somatization and disease phobia affected high FIQ scores independently of SSD, depressive disorder, and demoralization.

CONCLUSIONS

Defining health anxiety and pathological illness anxiety among the DSM-5 criteria as distinct diagnoses from SSD may increase the functional usefulness of DSM-5 in patients with fibromyalgia.