Disability and quality of life in patients with fibromyalgia

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Abstract

Background

Patients with fibromyalgia often feel disabled in the performance of daily activities. Psychological factors seem to play a pronounced disabling role in fibromyalgia.

The objectives of the study are: Firstly, to investigate contributing factors for disability in fibromyalgia. Secondly, to study psychological distress in patients with fibromyalgia as compared to other nonspecific pain syndromes. And finally, to explore the impact of fibromyalgia on a patient's quality of life.

Methods

In this cross sectional study, explaining factors for disability were studied based on a regression analysis with gender, mental health, physical and social functioning as independent variables. For the assessment of disability in fibromyalgia the FIQ was used. The levels of psychological distress in patients with fibromyalgia, Complex Regional Pain Syndrome (CRPS) and chronic low back pain (CLBP) were compared based on scores on the Symptom Checklist (SCL90). Quality of life of patients with fibromyalgia was compared with scores (SF36) of both patients with fibromyalgia and other health conditions as derived from the literature.

Results

Disability in fibromyalgia seemed best explained by a patients mental health condition (β = -0.360 p = 0.02). The level of psychological distress was higher in patients with fibromyalgia as compared to patients with CRPS or CLBP (p < 0.01). The impact of fibromyalgia on quality of life appeared to be high as compared to the impact of other health conditions.

Conclusion

Patients with fibromyalgia report a considerable impact on their quality of life and their perceived disability level seems influenced by their mental health condition. In comparison with patients with other pain conditions psychological distress is higher.

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Most cited references 33

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The role of fear of movement/(re)injury in pain disability.

J Vlaeyen, James Kole, R Ruesink … (1995)

It is now well established that in chronic low back pain, there is no direct relationship between impairments, pain, and disability. From a cognitive-behavioral perspective, pain disability is not only influenced by the organic pathology, but also by cognitive-perceptual, psychophysiological, and motoric-environmental factors. This paper focuses on the role of specific beliefs that are associated with avoidance of activities. These beliefs are related to fear of movement and physical activity, which is (wrongfully) assumed to cause (re)injury. Two studies are presented, of which the first examines the factor structure of the Tampa Scale for Kinesiophobia (TSK), a recently developed questionnaire that is aimed at quantifying fear of movement/(re)injury. In the second study, the value of fear of movement/(re)injury in predicting disability levels is analyzed, when the biomedical status of the patient and current pain intensity levels are controlled for. In addition, the determinants of fear of movement/(re)injury are examined. The discussion focuses on the clinical relevance of the fear-avoidance model in relation to risk assessment, assessment of functional capacity, and secondary prevention.

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Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study.

H. Susan J. Picavet, N Hoeymans (2004)

To examine the health related quality of life of persons with one or more self reported musculoskeletal diseases, as measured by the short form 36 item health status survey (SF-36) and the Euroqol questionnaire (EQ-5D). A sample of Dutch inhabitants aged 25 years or more (n = 3664) participated in a questionnaire survey. Twelve lay descriptions of common musculoskeletal diseases were presented and the subjects were asked whether they had ever been told by a physician that they had any of these. Their responses were used to assess the prevalence of these conditions. Commonly used scores of SF-36 and descriptive scores from EQ-5D are presented, along with standardised differences between disease groups and the general population. with musculoskeletal diseases had significantly lower scores on all SF-36 dimensions than those without musculoskeletal disease, especially for physical functioning (SF-36 score (SE), 75.2 (0.5) v 87.8 (0.5)); role limitations caused by physical problems (67.1 (0.9) v 85.8 (0.8)); and bodily pain (68.5 (0.5) v 84.1 (0.5)). The worst health related quality of life patterns were found for osteoarthritis of the hip, osteoporosis, rheumatoid arthritis, and fibromyalgia. Those with multiple musculoskeletal diseases had the poorest health related quality of life. Similar results were found for EQ-5D. All musculoskeletal diseases involve pain and reduced physical function. The coexistence of musculoskeletal diseases should be taken into account in research and clinical practice because of its high prevalence and its substantial impact on health related quality of life.

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Prevalence of self reported musculoskeletal diseases is high.

Johanna M. W. Hazes, H. Susan J. Picavet (2003)

To present the prevalence of self reported musculoskeletal diseases, the coexistence of these diseases, the test-retest reliability with six months in between, and the association with musculoskeletal pain symptoms. Twelve layman descriptions of common musculoskeletal diseases were part of the questionnaires of a prospective cohort study of a random sample in the general Dutch population aged 25 years or more (baseline: n=3664, follow up after six months: n=2338). Data collection also included information about pain relating to five different anatomical areas. Osteoarthritis of the knee (men 10.1%, women 13.6%) was amongst the most reported musculoskeletal diseases, whereas the figures for self reported rheumatoid arthritis (RA) were 1.6% and 4.6% for men and women, respectively. The coexistence of these diseases is high: 47 of the 66 combinations were reported more often than would be expected if they were independent of each other (p<0.05). For most diseases the test-retest reliability was good (kappa between 0.6 and 0.8), but for repetitive strain injury (kappa=0.37) and chronic arthritis other than RA (kappa=0.44) the agreement was fair to moderate. All complaints of pain were more often reported by those with musculoskeletal diseases than those without those diseases, and the pain pattern was disease-specific. Self reported musculoskeletal diseases are highly prevalent, with a fair to good reliability and a disease-specific pain pattern. Health surveys are a limited but valuable source of information for this group of health problems, which is not available from most other sources of information.

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Author and article information

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central

ISSN (Electronic): 1477-7525

Publication date Collection: 2008

Publication date (Electronic): 22 January 2008

Volume: 6

Page: 8

Affiliations

[1 ]Rehabilitation Foundation Limburg, P.O. Box 88, 6430 AB Hoensbroek, The Netherlands

[2 ]Department of Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

[3 ]Department of General Practice, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

[4 ]Laurentius Hospital, Mgr.Driessenstraat 6, 6043 CV Roermond, The Netherlands

[5 ]Blixembosch Rehabilitation Centre, P. O. Box 1355, 5602 BJ Eindhoven, The Netherlands

Article

Publisher ID: 1477-7525-6-8

DOI: 10.1186/1477-7525-6-8

PMC ID: 2265693

PubMed ID: 18211701

SO-VID: f9456622-56a1-4cac-8480-a434d7757155

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disability and quality of life in patients with fibromyalgia

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Abstract

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Most cited references 33

The role of fear of movement/(re)injury in pain disability.

Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study.

Prevalence of self reported musculoskeletal diseases is high.

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