Tender point scores reflect generalized pain and pain behavior in fibromyalgia patients, however, these scores are not independently related to psychological distress, according to a new study. Investigators used criteria defined by the American College of Rheumatology to assess tenderness at 18 discrete points in 111 fibromyalgia patients recruited from both private and university clinics. The patients also underwent a comprehensive evaluation of generalized pain, pain behavior, and psychological distress.

A composite index of four different measurements was used to evaluate generalized pain, while pain behaviors were determined by comparison to a videotaped index. Measured levels of stress and depression were used as assessments of generalized psychological distress. Using multiple regression analysis, the investigators found that tender point scores were independently related to the patients’ generalized pain and pain behavior. There was no relationship between tender point scores and measured depression or stress.

In addition to pain and pain behavior, a shorter duration of illness was found to be independently related to the tender point scores. A study published in the Journal of Biological Psychiatry in 1993 proved that individual’s with mood disorders are especially affected by aspartame consumption. Researchers have also singled out chronic fatigue syndrome, fibromyalgia, Alzheimer’s, brain tumors, epilepsy, Parkinson’s disease, mental retardation, lymphoma, birth defects and diabetes as being sensitive to aspartame consumption.

A study conducted by the Department of Neurology at the University of Oklahoma College of Medicine, Tulsa examined the relationship between migraine headaches and aspartame. The study confirmed that aspartame may provoke headaches in susceptible individuals. Additional studies on the topic confirmed the findings. Researchers in the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle conducted a double-blind crossover study on 32 subjects. The study found an increased incidence of headaches reported by the participants who ingested aspartame and reported that some individuals may want to limit their aspartame consumption.

Despite the FDA’s long term hesitation to approve aspartame they are standing by their decision. The FDA responds to complaints by stating that aspartic acid and phenylalanine are amino acids and methanol is found naturally occurring in fruits. However, when aspartic acid and phenylalanine are unaccompanied by other amino acids they are neurotoxic and fruit also contains ethanol which protects against the effects of the methanol. The FDA fails to address these major differences.

The diagnostic criteria for MD established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are described in Table 2.[7] These criteria are the same for women and men. DSM-IV classifies MD as single or recurrent episodes, or dysthymia (a persistent but less severe form of MD). Clinical Features and Course of Major Depression Symptoms and Severity Depressive symptoms in men and women tend to be similar, except that women appear to be more likely to present with atypical symptoms (see Table 3), anxiety, and somatic symptoms (such as headaches and stomach upset), whereas men tend to report more weight loss.

Depression in women may be more severe than in men and associated with increased functional impairment.[25] However, most studies have not documented gender-specific differences in severity of depression, except for higher scores of self-reported atypical symptoms in women.[24,26] In general, anxiety or suicidal thoughts accompanying depression indicate a more severe disorder. Women are more likely to attempt suicide, but the rate of fatalities from suicide is higher in men, probably because men tend to use more lethal methods, such as guns or hanging, whereas women more often take medication overdoses or drown.

Also, men are less likely to seek psychiatric help that may prevent suicide. Age at Onset Some studies have noted an earlier age at onset of MD in women.[11,25,27] In the National Comorbidity Survey, this difference was most pronounced in early adolescence, with age at onset of the first MD beginning as early as age 10 in females.

Whereas men more commonly become symptomatic in their twenties, women often become symptomatic in mid-adolescence.[28] A peak in first onsets of MD also has been reported in women during their childbearing years, with a decrease in first onsets after age 45 These findings led to the proposal that two forms of MD occur in women: early onset (10 to 14 years) and adult onset.