Abstract
The Fibromyalgia Survey Diagnostic Criteria-2016 (FSD-2016 criteria) were recently recommended for both clinical and research purposes. The present study aims to examine whether there is concordance between clinician-based and FSD-2016 criteria-based diagnoses of FM, and secondly, to examine how the illness severity and physical function relate to the criteria-based diagnosis among patients referred to a rheumatism hospital. Participants with a clinician-based diagnosis of FM were included consecutively when referred to a patient education programme for patients with FM. Illness severity was assessed with the Fibromyalgia Survey Questionnaire (FSQ). Based on the FSQ, the fulfilment of the FSD-2016 criteria was evaluated. Physical function was assessed using the Fibromyalgia Impact Questionnaire (FIQ) function scale and self-reported employment status. The sample included 130 patients (84% women) from 20 to 66 years of age. Eighty-nine per cent met the FSD-2016 criteria, and 44% of the patients were fully or partially employed. Great variability in illness severity was seen irrespective of employment status. There was an association between illness severity and physical function (r=0.4, p<0.001). For 95% of the patients, the FSQ illness severity scores classify as severe or very severe, and even for those not fulfilling the diagnostic criteria the scores were moderate and severe. There was relatively high agreement between clinician- and criteria-based diagnoses. The illness severity overlapped irrespective of different employment status and fulfilment of FSD-2016 criteria.
Highlights
Fibromyalgia (FM) is a contested widespread musculoskeletal pain condition that cannot be confirmed by laboratory or radiological assessments
The present study aims to examine whether there is concordance between clinician-based and FSD-2016 criteria-based diagnoses of FM, and secondly, to examine how the illness severity and physical function relate to the criteria-based diagnosis among patients referred to a rheumatism hospital
Illness severity was assessed with the Fibromyalgia Survey Questionnaire (FSQ)
Summary
Fibromyalgia (FM) is a contested widespread musculoskeletal pain condition that cannot be confirmed by laboratory or radiological assessments. Patients experience persistent pain with an unpredictable fluctuating intensity [1], and they report multiple other problems, e.g. pronounced fatigue, sleep and concentration problems, depression, headache, irritable bowel, and impaired functioning [2]. FM is explained by multiple interacting mechanisms such as hypersensitivity of the central nervous system, deficits in endogeneous pain inhibition, alterations in the neuroendocrine system, autonomic nervous system, immune system and stress regulation mechanisms, and by genetic vulnerability and psychological mechanisms [3,4,5]. Patients are often sent to various medical specialists for diagnostics [7], and it may take years to arrive at a FM diagnosis [7]. It can be a relief to get a diagnosis confirming not having a progressive or fatal
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