Abstract
The paper analyses the article devoted to the examination of relationships between inflammatory abnormalities in fibromyalgia, psychological distress, and hormonal aging. Although fibromyalgia is primarily associated with chronic widespread pain and somatic symptoms, the inflammatory response is commonly observed in diagnosed patients. At the same time, the largest part of patients with the disorder have symptoms of depression, anxiety, and other forms of psychological distress which are commonly regarded as potential activators of inflammatory processes.
Introduction
In their article “Proinflammatory cytokines and DHEA-S in women with fibromyalgia: Impact of psychological distress and menopausal status,” Sturgeon et al. (2014) evaluate the role of salient patient characteristics such as psychological stress and menopause on the elevation of inflammatory processes in women diagnosed with fibromyalgia to investigate the influence of psychological functioning on inflammation developing during the course of disorder’s progression.
Although fibromyalgia is not considered an inflammatory disorder and is primarily associated with widespread bodily pain, fatigue, and somatic symptoms, such as headaches, the evidence provided by the study demonstrates that inflammatory processes can be frequently observed in patients with this disease.
The mechanisms activating fibromyalgia are diverse – “central nervous system sensitization, sleep disturbance, affective dysregulation, and genetic abnormalities,” – while inflammation symptoms associated with the disorder are regarded as “contributory factors” to fibromyalgia (Sturgeon et al., 2014, p. 707). The inflammatory abnormalities are provoked by the immune response mediated through the release of proinflammatory cytokines activated by an inflammatory stimulus. It is observed that patients with fibromyalgia have high levels of inflammatory cytokines and chemokines that are commonly correlated with psychiatric characteristic including major depression and fatigue which are associated with cumulative effects of distress.
Sturgeon et al. (2014) state that psychological stress is common in fibromyalgia and over 65% percent of the diagnosed population have symptoms of depression, anxiety, and psychiatric distress. It is considered that stress and cytokine activity associated with it have an impact on the progression of inflammatory processes. It is identified that major depression and anxiety are correlated with the presence of such inflammatory markers like IL-6 TNF-α, IL-8, and DHEA-S which make significant contributions to inflammatory dysregulation. Based on this, the researchers regard psychological risk factors as crucial factors defining relations between fibromyalgia and increased cytokine levels.
The study sample comprised thirty-four postmenopausal and premenopausal women whose pain, depression, and anxiety anxiety-related indicators were measured through the administration of multiple standardized tests such as the Pain Anxiety Symptoms Scale 40-Item Version and the Pain Catastrophizing Scale. The researchers also sampled the participants’ TNF-α, IL-6, IL-8, IL-10, and DHEA-S levels which then were analyzed considering demographic, biological, psychological, and cytokine variables.
Sturgeon et al. (2014) found out that IL-8 was correlated with depressive characteristics and pain-related anxiety in women with complete menopause, and IL-6 was linked to psychological stress in all study participants. The researchers emphasize the significance of studying inflammatory factors with consideration of patients’ aging milestones and psychological health to be able to understand their implications in fibromyalgia more thoroughly. Sturgeon et al. (2014) expected that “menopausal status would modify the salience of IL-6/IL-10 ratios in the context of psychological functioning” but the research findings did not support this hypothesis (p. 213).
At the same time, the researchers came to the conclusion that there may be dynamic relations between anxiety and stress-related DHEA-S and inflammatory responses. However, DHEA-S’s impacts are multilateral and complex to be simply characterized by correlations with cytokine levels and psychological symptoms. Therefore, further investigation of biological, demographic, and psychological stress variables is suggested.
References
Sturgeon, J., Darnall, B., Zwickey, H., Wood, L., Hanes, D., Zava, D., & Mackey, S. (2014). Proinflammatory cytokines and DHEA-S in women with fibromyalgia: Impact of psychological distress and menopausal status. Journal of Pain Research, 2014(7), 707-716. Web.