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Evidence of disordered symptom appraisal in fibromyalgia (FM): increased rates of reported comorbidity & comorbidity severity

  [ 42 votes ]   [ Discuss This Article ] • May 5, 1999

OBJECTIVE: Using a large series of unselected consecutive patients,
to investigate whether patients with fibromyalgia differ from
those with rheumatoid arthritis (RA) or osteoarthritis (OA) in
the number of reported comorbid conditions and in their
perceived importance, and thereby to investigate differences
in symptom appraisal and somatization.

METHOD: In a clinical
care setting, 1,298 patients with fibromyalgia and 2,396 with
RA or OA participating in longitudinal data bank research as
part of their routine medical care completed questionnaires
concerning the presence or absence of 23 comorbid conditions,
and then rated the current importance of each condition to
them. Additional information concerning psychological factors
and disease severity was also obtained.

RESULTS: In analyses
adjusted for age and sex, patients with fibromyalgia reported
more conditions (4.5 vs. 3.1) than those with RA or OA. In 17
of 23 conditions, the condition was more commonly reported in
fibromyalgia than in RA or OA. In 20 of the 23 conditions, the
importance attached to the conditions by fibromyalgia patients
exceeded that of the importance attributed by RA/OA patients.
After adjustment for anxiety, statistical differences between
the groups for importance was lost for 6 conditions.

CONCLUSIONS: Fibromyalgia patients report more medical
conditions and report that they are more important to them
than do patients with RA or OA. These differences extend to
conditions that might be expected to cause symptoms, as well
as to those that are usually symptom free. These data suggest
that, on average, patients with fibromyalgia appraise medical
symptoms and their importance differently from patients with
other rheumatic conditions.

Wolfe F, Hawley DJ

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