Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact.

Objective: The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population.Methods: Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ).Results: Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI; r = 0.57, p < .001), anxiety (BAI; r = 0.56, p < .001) and childhood ADHD symptoms (WURS; r = 0.41, p < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ).Conclusion: Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease.

Cross-cultural adaptation of the Orebro Musculoskeletal Pain Questionnaire among Turkish workers with low back pain.

BACKGROUND: Psychosocial risk factors are very important in the development of chronicity in low back pain. And Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) is the screening instrument concerning these psychosocial and work-related risk factors in patients with low back pain. OBJECTIVE: The purpose of the study was to evaluate the reliability and construct validity of Turkish version of the ÖMPQ in patients with low back pain. METHODS: Turkish ÖMPQ was developed using the ``forward-backward translation'' method. It was administered to 120 working Turkish patients with acute-subacute low back pain. Test-retest reliability was assessed by intraclass correlation coefficients and internal consistency was assessed by Cronbach's alpha. Concurrent construct validity was evaluated by correlating the ÖMPQ with Oswestry Disability Index (ODI), fear avoidance beliefs questionnaire (FABQ), clinical and demographical variables and assessed with principal component analysis. RESULTS: The Turkish versions was re-tested for 110 patients with acute-subacute low back pain. Test-retest reliability was high with intraclass correlation coefficients of 0.93. Internal consistency was 0.96. The ÖMPQ score correlated highly (r> or = 0.60) with VAS-pain, ODI and sick-leave days; moderately (0.30 < r < 0.60) with FABQ and weakly (r< 0.30) with duration of pain and Schober test. Principal-components analysis revealed 3 factors explaining 43% of the variance. ÖMPQ had moderate predictive validity (AUC: 0.66; 95% CI 0.54; 0.81) in identifying patients with spinal pain that were under risk of long-term sick leave (> 15 days). The sensitivity was 0,54 and the specificity was 0.97. CONCLUSION: Turkish version of ÖMPQ is a valid, reliable, and acceptible instrument among Turkish working population with low back pain.

Do new diagnostic criteria for fibromyalgia provide treatment opportunity to those previously untreated?

BACKGROUND AND OBJECTIVES: It has been known that tender points detected by ACR 1990 criteria alone might not describe the essence of fibromyalgia, so preliminary diagnostic ACR 2010 criteria was developed. Since there has been no clear evidence exist examining the concordance rates and sensitivity to treatment of these two criteria comparatively, we aimed to shed light on this ambiguity. MATERIAL AND METHODS: [corrected] One hundred patients with widespread pain were studied. Fulfillment of both criteria was determined at baseline, at 3th and 12th months. Sensitivity and specificity values were identified. The relationship between Fibromyalgia Impact Questionnaire and components of two criteria was detected by pearson correlation. And the concordance rate was evaluated by kappa coefficient. RESULTS: At the 1st visit (baseline), two criteria were concordant in 48.5% (n=49) of cases (κ=0.43[95%CI.0.22,0.58]). However, the concordance was present in only 25(25%) of the subjects (κ=0.29[95%CI:0.12,0.36]) at the end of the study. After 1 year of follow-up, the sensitivity of ACR 2010 was higher than that of ACR 1990 (0.88; 0.56 respectively) (p< 0.05). CONCLUSION: ACR 2010 criteria is more sensitive than ACR 1990 both at first diagnosis and after 1 year of follow-up. So; it enables to diagnose and may give oppurtunity to treat more underdiagnosed FM patients.