Does Education Level Play a Role in Patient Perception of Fibromyalgia Symptom Severity?

The Association of Socioeconomic Status and Symptom Severity in Persons with Fibromyalgia.

By Mary-Ann Fitzcharles, et al.

Abstract:

OBJECTIVE: Although persons with lower socioeconomic status (SES) generally have poorer health status for many medical conditions, the association of SES with symptom severity in fibromyalgia (FM) is unknown. The subjective symptoms of FM may be influenced by personal perceptions, and environmental and psychosocial factors. Therefore SES may influence symptom expression and severity.

METHODS: Data for this cross-sectional analysis were obtained from a real-life prospective cohort of 246 patients with FM categorized according to level of education: high school graduates or less (Group 1; n = 99), college graduates (Group 2; n = 84), and university graduates (Group 3; n = 63). The association between level of education, a well-validated measure of SES, and disease severity, functional status, and quality of life were examined.

RESULTS: Lower education was significantly associated with older age (p = 0.039), current unemployment (p < 0.001), and more severe disease, as measured by patient global assessment disease activity (p = 0.019), McGill Pain Questionnaire (p = 0.026), Pain Disability Index (p = 0.031), Pain Catastrophizing Scale (p = 0.015), Health Assessment Questionnaire (p = 0.001), and Fibromyalgia Impact Questionnaire (p = 0.002), but not pain level, anxiety, or depression. These associations remained significant even upon adjusting for age and sex differences.

CONCLUSION: Patients with FM and lower SES, as assessed by education level, reported greater symptom severity and functional impairment, despite reporting similar levels of pain, depression, and anxiety. Although FM spans all socioeconomic groups, factors other than specific disease characteristics or mental status, appear to play an important role in patients’ perception of illness.

Source: The Journal of Rheumatology, June 15, 2014. By Mary-Ann Fitzcharles, Emmanouil Rampakakis, Peter A. Ste-Marie, John S. Sampalis and Yoram Shir. From the Division of Rheumatology, McGill University Health Centre, Montreal; JSS Medical Research, St-Laurent; Jewish General Hospital, McGill University, Montreal; and Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Quebec, Canada.

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One thought on “Does Education Level Play a Role in Patient Perception of Fibromyalgia Symptom Severity?”

  1. IanH says:

    ” Patients with FM and lower SES, as assessed by education level, reported greater symptom severity and functional impairment, despite reporting similar levels of pain, depression, and anxiety. Although FM spans all socioeconomic groups, factors other than specific disease characteristics or mental status, appear to play an important role in patients’ perception of illness. ”

    This is unreliable.
    Firstly SES is assessed only by Ed. status. While Ed. status is correlated to SES it is NOT SES. for example, there are many spouses of high educational individuals who themselves are not Hi Ed. Status but are living in high SES.
    Secondly, how do you report more severe symptom severity but similar pain levels in FM???
    what symptoms are they that dont relate to pain in FM?
    Thirdly, to go from such weak associations to “perception” of illness is very spurious.

    In summary: on the basis of this study, I doubt that patient’s perception of the illness is a function of SES. ie I doubt that people from lower SES percieve their illness worse than those from higher SES.

    To some degree I do believe that lower SES may cause worse symptoms of the illness, Why?
    Because people in a lower SES work more physically than people in a higher SES. People in a lower SES might find it harder to reduce their work/workload than those in a higher SES so therefore exacerbate their illness.

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