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Fibromyalgia Patients Should Be Screened for ADHD, Study Says

A recent study concludes that fibromyalgia and ADHD may frequently co-occur — possibly resulting in increased symptom severity for one or both conditions.




December 15, 2017

A small observational study found high rates of comorbidity between ADHD and fibromyalgia, a chronic pain disorder, as well as some evidence that patients with both conditions experience heightened symptom severity. Though the study’s data is preliminary, its authors concluded that patients with fibromyalgia should receive pre-emptive ADHD screenings.

The study1 was published in November in the journal Pain Medicine. Researchers tested 123 patients — all whom had been previously diagnosed with fibromyalgia — for ADHD, using the World Health Organization Adult ADHD Self-Report Scale. Fibromyalgia severity was also measured, using a widely recognized symptom scale called the Revised Fibromyalgia Impact Questionnaire (FIQ-R).

Nearly half of the patients — 44.7 percent — tested positive for ADHD. Those with ADHD were more likely to have symptoms of anxiety and depression, and higher FIQ-R scores. In fact, subjects in this group were particularly impacted by a fibromyalgia symptom called dyscognition, the researchers said.

Fibromyalgia’s most common (and well known) symptoms include muscle pain and fatigue. The condition, however, also includes a range of symptoms affecting memory, attention, and concentration, known collectively as dyscognition. Dyscognition may be “more disabling than chronic pain,” the study’s authors write, but is mostly under-recognized or under-treated. They concluded that the higher FIQ-R scores “could possibly be attributed to both the impact of dyscognition and the higher frequencies of anxiety and/or depression in patients with unrecognized adult ADHD.”

The study’s size means its conclusions should be verified; it’s unclear if symptoms of dyscognition and ADHD could overlap or be mistaken for one another. Still, the authors recommend that all fibromyalgia patients be screened for ADHD, as proper treatment could help manage more difficult memory- and cognition-related symptoms.


1 Van Rensburg, Roland, et al. “Screening for Adult ADHD in Patients with Fibromyalgia Syndrome.” Pain Medicine, Jan. 2017, doi:10.1093/pm/pnx275.

2 Related Links

  1. It is of note that the association between fibromyalgia and ADHD has been recognised for some time- since prior to 2003 at least.
    The entity of “affective spectrum disorder was first proposed by Hudson et al in 1990, and the fibromyalgia syndrome was added to the spectrum between then and the publication of this paper in 2003.

    https://jamanetwork.com/journals/jamapsychiatry/fullarticle/207153

    Now I have recently seen the argument put that many of the symptoms in ADHD are driven by orthostatic intolerance. I agree that that is likely- it fits many observations that I have made both of myself and my ADHD friends. However, what follows is more systematic than I can offer:
    https://www.youtube.com/watch?v=FxjSYRWrJB8&t=16s
    That is enough to explain much ADHD symptomatology, though maybe not all.

    There have been repeated observations of both orthostatic intolerance and of connective tissue hyperflexibility in the fibromyalgia patient group.
    I suggest that the connective tissue may be the common factor, and that those of us who fall into this group have a greater degree of hyperflexibility and are more likely to be injured by the habit of sitting in a chair and being sedentary. In fact we may not become symptomatic at all if we are more physically active.

    I am not enormously impressed by the use of the SRS-A as a screening tool for this kind of study– simply because it is inadequate to identify a childhood history of symptoms- and if you don’t have a childhood history you do not have ADHD.

  2. I think I’ve had fibromyalgia for many years but was diagnosed approximately 5 years ago. I was working at Walmart and was just exhausted. Not the tiredness that sleep helps. I mean totally exhausted, with muscle pain. My primary doctor diagnosed fibromyalgia. He  prescribed Cymbalta around 4 years ago. Cymbalta was approved for Fibromyalgia treatment. Although it did relieve some of the pain, I still suffered from fatigue. November 2017  my doctor started me on Natural Herbal Gardens fibromyalgia Herbal mixture,With the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using diet, herbs, which i feel has made the most difference. The Fibromyalgia natural formula immensely helped my condition, it reversed my Fibromyalgia. my muscle pain. And then the joint stiffness, and fatigue. gradually disappeared. and i turned 69 today. i am glad to get my life back, I will keep sharing awareness DON’T GIVE UP HOPE!!!

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