FIBROMYALGIA: DEPRESSION DEGREE, PAIN INTENSITY AND SLEEP DISTURBANCES AS QUANTITATIVE INDICATORS OF SYNDROME SEVERITY

The problem of fibromyalgia as the chronic pain syndrome becomes an actual problem of modern medicine, because of the high prevalence (up to 7-10% of the population), a significant reduction of life quality, sleep and a sharp limitation of patients' activity. Fibromyalgia syndrome characterized by generalized pain, the presence of tender areas, sleep disturbances and severe fatigue has no quantitative characteristics despite the availability of reliable clinical diagnostic criteria. Therefore, a paradoxical situation is formed, when both clinical syndrome and even the scheme of disease management are well described, but reliable conventional criteria of disease severity do not exist yet. As a result of a long-term study of 151 patients with fibromyalgia, quantitative indicators of depression, pain intensity and sleep disturbances were recorded, which revealed the presence of a convincing connection between these indicators and the severity of fibromyalgia. As a result of the conducted study it was revealed that with disease duration of 1-3 years the percentage of patients with pain intensity of more or less than 5 points by visual analogue scale was approximately the same and accounted for 51.9% and 48.1%, respectively. A progressive increase of patients (up to 64.1% and 73.5%) with pain intensity syndrome of more than 5 points was noticed among patients whose disease duration was up to 3-5 years. It was established that unlike the dynamics observed in case of pain, the indicator of sleep disturbance intensity is gradually reduced with the increase of fibromyalgia duration. During the observation of depression indicators, it was noticed that the longer fibromyalgia duration, the lower the percentage of patients without depression signs. It is notable that among the group of patients with disease duration of more than 5 years a sharp increase is noticed in the number of patients with major depression and this happens by the reduction of specific proportion of patients with moderate depression. These findings are consistent with the results of a number of authors, according to which depressive disturbances are observed in approximately 90% of patients with fibromyalgia and major depression - in 62-86% of cases. Thus, it should be established that the parallelism is observed in the escalation of depression and the severity of pain syndrome with the increase of disease duration in patients with fibromyalgia, which is accompanied by the reduction of sleep disturbances' severity indicator.