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Some Researchers Contend Fibromyalgia Is a Spectrum Disorder

  [ 2 votes ]   [ Discuss This Article ] • February 21, 2013


Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: Results from a survey of the general population.
– Source: Arthritis Care and Research, February 19, 2013

By. F. Wolfe, et al.


To evaluate fibromyalgia in the general population with emphasis on prevalence, dimensionality, and somatic symptom severity.

METHODS: We studied 2,445 subjects randomly selected from the German general population in 2012 using the American College of Rheumatology 2010 preliminary diagnostic criteria for fibromyalgia, as modified for survey research, and the polysymptomatic distress scale (PSD). Anxiety, depression and somatic symptom severity were assessed with the Patient Health Questionnaire (PHQ) series, and measures of symptoms and quality of life with the European Organization for Research and Treatment of Cancer (EORTC) questionnaire.


  • The prevalence of fibromyalgia was 2.1% (1.6, 2.7); 2.4% (1.5, 3.2) in women and 1.8% (1.1, 2.6) in men, but the difference was not statistically significant.

  • Prevalence rose with age.

  • Fibromyalgia subjects had markedly abnormal scores for all covariates.

  • We found smooth, non-disordered relationships between PSD and all predictors, providing additional evidence against the hypothesis that fibromyalgia is a discrete disorder and in support of a dimensional or spectrum disorder.

  • There was strong correlation (r=0.790) between the PSD and the PHQ somatic symptom severity scale; 38.5% of persons with fibromyalgia satisfied the proposed DSM V criteria for a Physical Symptom Disorder

 CONCLUSIONS: The modified 2010 diagnostic criteria do not result in high levels of fibromyalgia. PSD and fibromyalgia are strongly related to somatic symptom severity. There is evidence in support of fibromyalgia as a dimensional or continuum disorder. This has important ramifications for neurobiologic and epidemiology research, and for clinical diagnosis, treatment, and ascertainment of disability.

Source: Arthritis Care and Research, February 19, 2013. By. F. Wolfe, E. Brähler, A. Hinz, W. Häuser. National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine, Wichita, Kansas; Department of Medical Psychology and Medical Sociology, Universität Leipzig, Germany; Department of Psychosomatic Medicine and Psychotherapy Technische Universität München, Munich, Germany and Department Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany. E-mail:

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