Major depression, fibromyalgia and labour force participation: A population-based cross-sectional study

Aliya Kassam¹ and Scott B Patten²^,3

¹Section of Community Psychiatry, Health Services Research Department, Institute of Psychiatry, King's College London, UK

²Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada

³Department of Psychiatry, University of Calgary, 1403 – 29 Street NW. Calgary, T2N 2T9, Canada

author email corresponding author email

BMC Musculoskeletal Disorders 2006, 7:4doi:10.1186/1471-2474-7-4


Published:	19 January 2006

Abstract

Background

Previous studies have documented an elevated frequency of depressive symptoms and disorders in fibromyalgia, but have not examined the association between this comorbidity and occupational status. The purpose of this study was to describe these epidemiological associations using a national probability sample.

Methods

Data from iteration 1.1 of the Canadian Community Health Survey (CCHS) were used. The CCHS 1.1 was a large-scale national general health survey. The prevalence of major depression in subjects reporting that they had been diagnosed with fibromyalgia by a health professional was estimated, and then stratified by demographic variables. Logistic regression models predicting labour force participation were also examined.

Results

The annual prevalence of major depression was three times higher in subjects with fibromyalgia: 22.2% (95% CI 19.4 – 24.9), than in those without this condition: 7.2% (95% CI 7.0 – 7.4). The association persisted despite stratification for demographic variables. Logistic regression models predicting labour force participation indicated that both conditions had an independent (negative) effect on labour force participation.

Conclusion

Fibromyalgia and major depression commonly co-occur and may be related to each other at a pathophysiological level. However, each syndrome is independently and negatively associated with labour force participation. A strength of this study is that it was conducted in a large probability sample from the general population. The main limitations are its cross-sectional nature, and its reliance on self-reported diagnoses of fibromyalgia.