The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey

Brian Walitt, Richard L Nahin, Robert S Katz, Martin J Bergman, Frederick Wolfe, Brian Walitt, Richard L Nahin, Robert S Katz, Martin J Bergman, Frederick Wolfe

Abstract

Background: Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail.

Methods: We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults.

Results: Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician's diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale.

Conclusions: Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Predicted probabilities (unadjusted) of selected…
Fig 1. Predicted probabilities (unadjusted) of selected variables in the 2012 National Health Interview Survey as a function of polysymptomatic distress scores.

References

    1. Wolfe F, Clauw D, Fitzcharles MA, Goldenberg D, Häuser W, Katz RS, et al. Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: A Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011;38:1113–22. 10.3899/jrheum.100594
    1. Wolfe F, Clauw D, Fitzcharles MA, Goldenberg D, Katz RS, Mease P, et al. The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care Res. 2010;62(5):600–10.
    1. National Center for Health Statistics. Data File Documentation, National Health Interview Survey, 2012 (machine readable data file and documentation) In: Statistics NCfH, editor. Hyattsville, Maryland: Centers for Disease Control and Prevention,; 2013. p. 1–135.
    1. Wolfe F, Brähler E, Hinz A, Häuser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthitis Care and Research. 2013;65(5):777–85. Epub February 19, 2013 (10.1002/acr.21931). 10.1002/acr.21931).
    1. Segura-Jiménez V, Aparicio VA, Álvarez-Gallardo IC, Soriano-Maldonado A, Estévez-López F, Delgado-Fernández M, et al. Validation of the modified 2010 American College of Rheumatology diagnostic criteria for fibromyalgia in a Spanish population. Rheumatology. 2014:keu169.
    1. Wolfe F, Michaud K. The National Data Bank for rheumatic diseases: a multi-registry rheumatic disease data bank. Rheumatology (Oxford). 2011;50(1):16–24. Epub 2010/06/23. keq155 [pii]10.1093/rheumatology/keq155 .
    1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis and rheumatism. 1990;33(2):160–72. .
    1. Royston P. Multiple imputation of missing values. Stata Journal. 2004;4(3):227–41.
    1. Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3(1):32–5.
    1. Organization WH. WHO Expert Committee on Physical Status: the use and interpretation of anthropometry phisical status Geneva: World Health Organization; 1995. WHO Technical Report Series 1995;854.
    1. Corporation S. Stata Statistical Software: Release 13.1. College Station, TX: Stata Corporation; 2013.
    1. Sacks JJ, Harrold LR, Helmick CG, Gurwitz JH, Emani S, Yood RA. Validation of a surveillance case definition for arthritis. JRheumatol. 2005;32(2):340–7. .
    1. Berger A, Dukes E, Martin S, Edelsberg J, Oster G. Characteristics and healthcare costs of patients with fibromyalgia syndrome. Int J Clin Pract. 2007;61(9):1498–508. Epub 2007/07/28. IJCP1480 [pii]10.1111/j.1742-1241.2007.01480.x .
    1. Schaefer C, Chandran A, Hufstader M, Baik R, McNett M, Goldenberg D, et al. The comparative burden of mild, moderate and severe fibromyalgia: results from a cross-sectional survey in the United States. Health Qual Life Outcomes. 2011;9:71 10.1186/1477-7525-9-71
    1. Wolfe F, Walitt BT, Katz RS, Häuser W. Social security work disability and its predictors in patients with fibromyalgia. Arthritis care & research. 2014.
    1. Raphael KG, Janal MN, Nayak S, Schwartz JE, Gallagher RM. Psychiatric comorbidities in a community sample of women with fibromyalgia. Pain. 2006;124(1–2):117–25. .
    1. Fietta P, Manganelli P. Fibromyalgia and psychiatric disorders. Acta Biomed. 2007;78(2):88–95. Epub 2007/10/16. .
    1. McBeth J, Silman AJ. The role of psychiatric disorders in fibromyalgia. CurrRheumatolRep. 2001;3(2):157–64.
    1. Jeffery DD, Bulathsinhala L, Kroc M, Dorris J. Prevalence, Health Care Utilization, and Costs of Fibromyalgia, Irritable Bowel, and Chronic Fatigue Syndromes in the Military Health System, 2006–2010. Military medicine. 2014;179(9):1021–9. 10.7205/MILMED-D-13-00419
    1. Hadler NM, Greenhalgh S. Labeling woefulness: the social construction of fibromyalgia. Spine. 2005;30(1):1–4. .
    1. Wessely S, Hotopf M. Is fibromyalgia a distinct clinical entity? Historical and epidemiological evidence. Baillieres BestPractResClinRheumatol. 1999;13(3):427–36. .
    1. Ehrlich GE. Pain is real; fibromyalgia isn't. JRheumatol. 2003;30(8):1666–7. .
    1. Pollard LC, Kingsley GH, Choy EH, Scott DL. Fibromyalgic rheumatoid arthritis and disease assessment. Rheumatology (Oxford). 2010;49(5):924–8. 10.1093/rheumatology/kep458 .
    1. Aaron LA, Buchwald D. A review of the evidence for overlap among unexplained clinical conditions. Ann Intern Med. 2001;134(9 Pt 2):868–81. Epub 2001/05/11. 200105011–00011 [pii]. .
    1. Dumit J. Illnesses you have to fight to get: Facts as forces in uncertain, emergent illnesses. Social Science & Medicine. 2006;62(3):577–90.
    1. Fink P, Toft T, Hansen MS, √òrnb√∏l E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosomatic Medicine. 2007;69(1):30–9.
    1. Fink P, Schroder A. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res. 2010;68(5):415–26. Epub 2010/04/21. S0022-3999(10)00075-9 [pii]10.1016/j.jpsychores.2010.02.004 .
    1. Wessely S, White PD. There is only one functional somatic syndrome. The British Journal of Psychiatry. 2004;185(2):95–6.
    1. Aronowitz RA. When do symptoms become a disease? Annals of internal medicine. 2001;134(9 Pt 2):803
    1. Kroenke K. Physical symptom disorder: a simpler diagnostic category for somatization-spectrum conditions. Journal of psychosomatic research. 2006;60(4):335–9.
    1. Kroenke K. Somatoform disorders and recent diagnostic controversies. Psychiatric Clinics of North America. 2007;30(4):593–619.
    1. Maeland S, Werner EL, Rosendal M, Jonsdottir IH, Magnussen LH, Ursin H, et al. Diagnoses of patients with severe subjective health complaints in Scandinavia: a cross sectional study. ISRN Public Health. 2012;2012.
    1. Wolfe F, Michaud K. Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize RA patients with fibromyalgia. JRheumatol. 2004;31(4):695–700. .
    1. Macfarlane GJ, Norrie G, Atherton K, Power C, Jones GT. The influence of socioeconomic status on the reporting of regional and widespread musculoskeletal pain: results from the 1958 British Birth Cohort Study. Annals of the rheumatic diseases. 2009;68(10):1591–5. 10.1136/ard.2008.093088
    1. Nimnuan C, Hotopf M, Wessely S. Medically unexplained symptoms: an epidemiological study in seven specialities. J Psychosom Res. 2001;51(1):361–7. Epub 2001/07/13. S0022-3999(01)00223-9 [pii]. .
    1. Kleinman A. The illness narratives: Suffering, healing, and the human condition: Basic Books (AZ); 1988.
    1. Kirmayer LJ, Sartorius N. Cultural models and somatic syndromes. Psychosomatic Medicine. 2007;69(9):832–40.
    1. Aceves-Avila FJ, Ferrari R, Ramos-Remus C. New insights into culture driven disorders. Best Pract Res Clin Rheumatol. 2004;18(2):155–71. Epub 2004/05/04. doi: [pii]. .
    1. Wolfe F, Hawley D. Evidence of disordered symptom appraisal in fibromyalgia: increased rates of reported comorbidity and comorbidity severity. Clinical and experimental rheumatology. 1998;17(3):297–303.
    1. Nicholl B, Macfarlane G, Davies K, Morriss R, Dickens C, McBeth J. Premorbid psychosocial factors are associated with poor health-related quality of life in subjects with new onset of chronic widespread pain: Results from the EPIFUND study. Pain. 2009;141(1):119–26.
    1. Macfarlane GJ, Morris S, Hunt IM, Benjamin S, McBeth J, Papageorgiou AC, et al. Chronic widespread pain in the community: The influence of psychological symptoms and mental disorder on healthcare seeking behavior. JRheumatol. 1999;26(2):413–9. .
    1. Clauw DJ. Fibromyalgia: A Clinical Review. JAMA. 2014;311(15):1547–55. 10.1001/jama.2014.3266
    1. Kendler KS. The Structure of Psychiatric Science. Perspectives. 2014;171(9).
    1. Kendler K. The dappled nature of causes of psychiatric illness: replacing the organic–functional/hardware–software dichotomy with empirically based pluralism. Molecular psychiatry. 2012;17(4):377–88. 10.1038/mp.2011.182
    1. Holliday KL, Macfarlane GJ, Nicholl BI, Creed F, Thomson W, McBeth J. Genetic variation in neuroendocrine genes associates with somatic symptoms in the general population: results from the EPIFUND study. Journal of psychosomatic research. 2010;68(5):469–74. 10.1016/j.jpsychores.2010.01.024
    1. Kato K, Sullivan PF, Evengard B, Pedersen NL. Chronic widespread pain and its comorbidities: a population-based study. ArchInternMed. 2006;166(15):1649–54. .
    1. Kato K, Sullivan PF, Evengard B, Pedersen NL. A population-based twin study of functional somatic syndromes. Psychological medicine. 2009;39(3):497 10.1017/S0033291708003784
    1. Buskila D, Sarzi-Puttini P, Ablin JN. The genetics of fibromyalgia syndrome. Pharmacogenomics. 2007;8(1):67–74. Epub 2006/12/26. 10.2217/14622416.8.1.67 .
    1. Wolfe F, Michaud K, Busch RE, Katz RS, Rasker JJ, Shahouri SH, et al. Polysymptomatic distress in patients with rheumatoid arthritis: understanding disproportionate response and its spectrum. Arthritis care & research. 2014;66(10):1465–71.
    1. Brummett CM, Janda AM, Schueller CM, Tsodikov A, Morris M, Williams DA, et al. Survey Criteria for Fibromyalgia Independently Predict Increased Postoperative Opioid Consumption after Lower-extremity Joint Arthroplasty: A Prospective, Observational Cohort Study. Anesthesiology. 2013;119(6):1434–43. 10.1097/ALN.0b013e3182a8eb1f
    1. Walitt B, Nahin RL, Katz RS, Bergman M, Wolfe F. Most persons with diagnosed with fibromyalgia do not have the disorder: the expansion of fibromyalgia by misdiagnosis, direct to consumer advertising, and diagnosis desirability. Abstract presented at the 2014 American College of Rheumatology annual meeting, Boston, MA. 2014.
    1. Wolinsky H. Disease mongering and drug marketing. EMBO reports. 2005;6(7):612–4.
    1. Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. Bmj. 2012;344:e3502 10.1136/bmj.e3502
    1. Moynihan R, Heath I, Henry D. Selling sickness: the pharmaceutical industry and disease mongeringCommentary: Medicalisation of risk factors. Bmj. 2002;324(7342):886–91.
    1. Barker KK. Listening to Lyrica: contested illnesses and pharmaceutical determinism. Social Science & Medicine. 2011;73(6):833–42.
    1. Epstein SA, Kay G, Clauw D, Heaton R, Klein D. Psychiatric Disorders in Patients With Fibromyalgia:: A Multicenter Investigation. Psychosomatics. 1999;40(1):57–63.
    1. McBeth J, Macfarlane GJ, Benjamin S, Silman AJ. Features of somatization predict the onset of chronic widespread pain: results of a large population-based study. Arthritis and rheumatism. 2001;44(4):940–6. Epub 2001/04/24. 10.1002/1529-0131(200104)44:4<940::AID-ANR151>;2-S .
    1. English B. Neural and Psychosocial Mechanisms of Pain Sensitivity in Fibromyalgia. Pain Management Nursing. 2014;15(2):530–8. 10.1016/j.pmn.2012.07.009
    1. Wolfe F, Walitt BT, Rasker JJ, Katz RS, Hauser W. The Use of Polysymptomatic Distress Categories in the Evaluation of Fibromyalgia (FM) and FM Severity. The Journal of rheumatology. 2015. 10.3899/jrheum.141519 .

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere