The London fibromyalgia (FM) Epidemiology Study: comparing the demographic & clinical characteristics in 100 random community cases of FM versus controls

OBJECTIVE: To identify demographic and clinical features that
distinguish fibromyalgia (FM) from other chronic widespread

METHODS: We identified 100 confirmed FM cases, 76
widespread pain controls, and 135 general controls in a random
community survey of 3395 noninstitutionalized adults living in
London, Ontario. FM cases were distinguished from pain
controls using the 1990 American College of Rheumatology (ACR)
classification criteria for FM.

RESULTS: The mean age of FM
cases was 47.8 years (range 19 to 86), the same as for pain
controls; 86% of FM cases were female versus 67.1% of pain
controls (p < 0.01). FM cases were less educated than general
controls (p = 0.03). Male and female FM cases were similar,
except females were older and reported more major symptoms
(both p = 0.02). FM cases reported more severe pain and
fatigue, more symptoms, more major symptoms, and worse overall
health than pain controls or general controls. The most
commonly reported major symptoms among FM cases were
musculoskeletal pain (77.3%), fatigue (77.3%), severe fatigue
lasting 24 h after minimal activity (77.0%), nonrestorative
sleep (65.7%), and insomnia (56.0%). Subjects with 11-14
tender points were more similar to those with 15-18 tender
points than to those with 7-10 points in 11 of 14 clinical
variables. On multivariate analysis, 4 symptoms distinguished
FM cases from pain controls: pain severity (p = 0.004), severe
fatigue lasting 24 h after minimal activity (p = 0.006),
weakness (p = 0.008), and self-reported swelling of neck
glands (p = 0.01).

CONCLUSION: In the general population,
adults who meet the ACR definition of FM appear to have
distinct features compared to those with chronic widespread
pain who do not meet criteria.

White KP, Speechley M, Harth M, Ostbye T

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