Ulla Maria Anderberg

Citalopram in patients with fibromyalgia - a randomized, double-blind, placebo-controlled study.

The effect of the selective serotonin reuptake inhibitor citalopram was studied in a randomized, double‐blind, placebo‐controlled, 4‐month trial in patients with the fibromyalgia syndrome (FMS) who all fulfilled the American College of Rheumatology criteria. The citalopram doses varied between 20–40 mg daily. Forty female patients, 21 patients in the citalopram and 19 in the placebo group, participated. Assessment of pain, depressive symptoms and physical functioning were made using Visual Analogue Scales (VAS), the Montgomery Åsberg Depression Rating Scale (MADRS) and the Fibrositis Impact Questionnaire (FIQ).

The impact of life events in female patients with fibromyalgia and in female healthy controls

The aim was to investigate if female fibromyalgia patients (FMS) had experienced more negative life events than healthy women. Furthermore, the life events experienced in relation to onset of the FMS were evaluated. Another important area was to investigate the impact of the events experienced in the patients compared to healthy women. A new inventory was constructed to assess life events during childhood, adolescence and in adulthood as well as life events experienced in relation to the onset of the disorder. Forty female FMS patients and 38 healthy age-matched women participated in the study. During childhood or adolescence 51% of the patients had experienced very negative life events as compared to 28% of the controls. Conflict with parents was the most common life event. Before onset, 65% of the patients experienced some negative life event. Economic problems and conflicts with husband/partner were common. During the last year, 51% of the patients had life events which they experienced as very negative, compared to 24.5% of the controls (P < 0.01). Stressful life events in childhood/adolescence and in adulthood seem to be very common in FMS. Furthermore, the life events were experienced as more negative than the life events experienced by healthy controls.

Pain Perception across the Menstrual Cycle Phases in Women with Chronic Pain

The menstrual cycle has been reported to alter pain perception but the patterns differ among studies. It has been reported that estrogens may influence somatic sensory processes. The present aim was to investigate whether the perception of pain varies by phases of the menstrual cycle. 20 women with chronic low pain volunteered to participate and were asked to rate their pain each day during three successive menstrual cycles. The menstrual cycle was divided into four and five phases to be able to compare results. Analysis showed there were phase differences in pain ratings during the menstrual cycle. Regardless of whether the menstrual cycle was divided into four or five phases, women rated pain significantly higher in the menstrual and premenstrual phases than in the midmenstrual and ovulatory phases. This is consistent with other studies showing less pain sensitivity during phases of the menstrual cycle associated with high estrogen. Women with high pain frequency reported more frequency a passive coping style and catastrophizing thoughts.

Psychophysiological effects of a web-based stress management system: A prospective, randomized controlled intervention study of IT and media workers (ISRCTN54254861)

BackgroundThe aim of the present study was to assess possible effects on mental and physical well-being and stress-related biological markers of a web-based health promotion tool.MethodsA randomized, prospectively controlled study was conducted with before and after measurements, involving 303 employees (187 men and 116 women, age 23–64) from four information technology and two media companies. Half of the participants were offered web-based health promotion and stress management training (intervention) lasting for six months. All other participants constituted the reference group. Different biological markers were measured to detect possible physiological changes.ResultsAfter six months the intervention group had improved statistically significantly compared to the reference group on ratings of ability to manage stress, sleep quality, mental energy, concentration ability and social support. The anabolic hormone dehydroepiandosterone sulphate (DHEA-S) decreased significantly in the reference group as compared to unchanged levels in the intervention group. Neuropeptide Y (NPY) increased significantly in the intervention group compared to the reference group. Chromogranin A (CgA) decreased significantly in the intervention group as compared to the reference group. Tumour necrosis factor α (TNFα) decreased significantly in the reference group compared to the intervention group. Logistic regression analysis revealed that group (intervention vs. reference) remained a significant factor in five out of nine predictive models.ConclusionThe results indicate that an automatic web-based system might have short-term beneficial physiological and psychological effects and thus might be an opportunity in counteracting some clinically relevant and common stress and health issues of today.

Predictors of self-rated health: a 12-month prospective study of IT and media workers

ObjectiveThe aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0–12 months).MethodsA prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23–64) from four information technology and two media companies.ResultsThere were a multitude of statistically significant cross-sectional correlations (Spearmans Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression).ConclusionThe results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

Personality traits on the basis of the Temperament and Character Inventory in female fibromyalgia syndrome patients

The study was designed to investigate personality traits in fibromyalgia syndrome (FMS) patients by means of the Temperament and Character Inventory (TCI) and, furthermore, to relate the personality traits to the presence of psychiatric disorders. Thirty-eight female FMS patients and sex- and age-matched healthy control subjects (HCS) completed the 238-item self-rating personality inventory TCI. The Structured Clinical Interview for DSM-III-R (SCID) I was used to determine psychiatric disorders. To expand the diagnostic procedure for depression, the self-rating Beck Depression Inventory (BDI) was also used. The results of the TCI rating showed that 82% of the FMS patients had a temperament type with high Harm Avoidance. The FMS patients scored significantly higher than the HCS in this variable (P=0.0001), regardless of concomitant psychiatric disorder. High Harm Avoidance is suggested to be strongly correlated to anxiety and depression. Thirty-seven per cent of the FMS patients fulfilled the SCID I criter...

Personality dimensions measured by the Temperament and Character Inventory (TCI) in subjects with social phobia.

The present study investigated personality dimensions by means of the Temperament and Character Inventory (TCI) in subjects with social phobia with or without a co-existing avoidant personality disorder. Thirty-one individuals with social phobia were recruited through advertisement and diagnosed with the Structured Clinical Interview for DSM-IV I and II psychiatric disorders. Comorbid Axis I psychiatric disorders were diagnosed in 29% of the cases. Co-occurring personality disorders were present in 55.8% of the cases, and avoidant personality disorder in 48.4%. The social phobia subjects, as compared to healthy controls of the same age, scored significantly higher in the TCI dimension measuring Harm avoidance but significantly lower in Persistence, Self-directedness, Cooperativeness and Self-transcendence. Presence of avoidant personality disorders in the social phobia subjects was associated with significantly higher Harm avoidance, particularly on the subscale Shyness with strangers. In conclusion, individuals with social phobia were characterized by high comorbidity of avoidant personality disorder and deviations in TCI personality dimensions. Enhanced Harm avoidance was the most prominent personality trait. The observed deviations in TCI dimensions were primarily related to the social phobia itself and not to the presence of concurrent personality disorders.

Elevated plasma levels of neuropeptide Y in female fibromyalgia patients.

Neuropeptide Y(NPY) co‐exists with norepinephrine in the sympathetic nervous system, and NPY may represent the sympathetic‐neuronal output. Fibromyalgia syndrome (FMS) patients have perturbations in the hypothalmic‐pituitary‐adrenal (HPA) axis and in the sympathetic stress axis as well. As opioid peptides, monoamines and sex steroids are integrated in the regulation of stress, it is interesting to further explore the role of NPY in FMS patients, as they show many symptoms that are related to perturbations of those systems.

Stress in migraine: personality-dependent vulnerability, life events, and gender are of significance.

Abstract Background and aim. The individuals experiences of stress as well as constitutional factors, including high neuroticism and female gender, are known determinants for migraine. The present aim was to further elucidate factors of personality and stress, including life events, in relation to gender in migraine. Methods. A cross-sectional study was performed on 150 persons, 106 women and 44 men, suffering from at least two migraine attacks a month. All obtained a doctor-defined migraine diagnosis based on a structured face-to-face interview concerning their health situation and current and prior stress. All of them also answered validated questionnaires regarding personality traits (SSP), life events, and perceived ongoing stress. Results. The personality trait inventory showed high mean scores for stress susceptibility and low mean scores for aggressiveness and adventure seeking, both for women and for men, as well as high mean scores for psychic and somatic anxiety in women. Stress susceptibility, the overall most deviant trait, correlated strikingly with current level of stress in both sexes. In women, stress susceptibility also correlated strongly with experiences of negative life events. Tension-type headache, anxiety, and depression were approximately twice as prevalent in women compared to men. Conclusions. The present study confirms previous research, showing that stress is an important factor in migraine. Stress susceptibility, life events, and concomitant psychosomatic illnesses should be considered important when evaluating individuals with migraine, and gender aspects need to be taken into account.

The role of life events in social phobia

The aim was to investigate the relationship between life events and social phobia. An inventory assessing life events during childhood, adulthood as well as life events experienced in relation to the onset of the disorder was administrated to 30 subjects with a DSM-IV diagnosis of social phobia. They were recruited by announcement and diagnosed by the Structured Clinical Interview for DSM-IV for axes I and II disorders. Seventy-five controls were selected by matching age and gender from the local population register. Individuals with social phobia reported significantly more life events during childhood and more life events with negative impact during the social phobia debuting year. Conversely, they described fewer events in the adult life than the controls. Close relatives with disabling conditions in the childhood, conflicts with wife/husband/cohabitant and divorces or similar were significantly more common in the debuting year in social phobic group. In adult life, the healthy individuals described significantly more often increased authority at work. A gender-specific analysis revealed significantly more experiences of a death of a relative/close friend during the year before the social phobia debut and significantly more negative life events in the womens adult life. In summary, the present results support that life events have a role in social phobia that may be gender influenced.