Abstract
INTRODUCTION: Fibromyalgia is characterized by chronic widespread pain and psychiatric comorbidities, but robust comparative data remain limited. METHODS: This retrospective cohort study compared psychiatric diagnoses and medication use among matched groups with fibromyalgia, chronic pain, chronic fatigue syndrome, rheumatoid arthritis, and healthy controls (total N=5,040), using data from a large national health care provider. RESULTS: Psychiatric disorders were most prevalent in fibromyalgia, followed by chronic pain, chronic fatigue syndrome, rheumatoid arthritis, and healthy controls. In fibromyalgia patients, anxiety (55.1%) and depression (48.7%) were predominant, accompanied by extensive medication use. Notably, fibromyalgia showed exceptionally high relative risks for Cluster B personality disorders (RR=34), personality disorders overall (RR=24), and PTSD (RR=22.75). CONCLUSIONS: Fibromyalgia patients experience significantly elevated psychiatric comorbidities compared with other chronic conditions. Comprehensive and integrated multidisciplinary care strategies are necessary to address the distinct psychiatric burden associated with fibromyalgia. This study extends prior work by directly comparing fibromyalgia to other chronic conditions and identifying distinct psychiatric risk patterns in a culturally diverse national cohort.