Invalidation in fibromyalgia and rheumatoid arthritis and its effect on quality of life in Indian patients.

Abstract

Fibromyalgia (FM) and rheumatoid arthritis (RA) patients face invalidation in the form of "discounting" and "lack of understanding". Invalidation can have effects on the quality of life (QoL) in these patients. We planned this study to look for invalidation in FM and RA Indian patients and see the correlation between invalidation and QoL. Invalidation was measured by the Illness Invalidation Inventory (3*I) to look for "discounting" and "lack of understanding" across sources, that is, spouse, family, medical professionals, work environment. QoL was measured using the World Health Organization QoL-BREF (WHOQoL). It covers mental, physical, psychological, and environmental domains. Fifty-five FM and 102 RA patients were included in the study. Compared to RA, FM patients had significantly higher discounting by spouse, family and medical professionals (P<.001). FM patients suffered more lack of understanding from spouse and medical professionals as compared to RA patients (P<.001). In RA patients discounting by spouse had weak to moderate negative correlation with psychological, social and environmental domains of WHOQoL (r -.26 to -.48). Lack of understanding by spouse had moderate negative correlation with all the domains of WHOQoL (r -.30 to -.40) and a weak correlation with disease duration (r .23) in RA. In FM discounting by spouse and medical professionals had weak to moderate negative correlation with the physical health domain of WHOQoL (r -.26 to -.30). FM patients faced more invalidation as compared to RA patients. Invalidation from spouse leads to poor QoL in RA and FM patients.