Skip to main content

Advertisement

Log in

Predictors of health status in women with fibromyalgia: A prospective study

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Although cross-sectional studies have identified correlates of dysfunction in fibromyalgia (FM) patients (e.g., psychological distress and pain), predictors of health status have not been previously investigated using a longitudinal research design. We gathered data from 156 women who met American College of Rheumatology criteria for primary FM recruited from both tertiary care and community settings. Stepwise multiple linear regression analysis indicated that poorer health status (p < .0001) and more comorbidity (p = .0089) at baseline were predictors of poorer health status 6 months later. After controlling for these covariates, psychological distress contributed significantly to the model (p = .01). There was a trend indicating that palliative coping styles (i.e., self-care, energy conservation) altered the impact of pain on 6-month health status (p = .06). These findings highlight the need for multidisciplinary interventions that target psychological distress, coping, and comorbidity in patients with FM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Bennett, R. M. (1996). Multidisciplinary group programs to treat fibromyalgia patients. Rheumatic Diseases Clinics of North America, 22, 351–367.

    Article  PubMed  Google Scholar 

  • Bergner, M. Bobbitt, R. A., Carter, W. B., & Gilson, B. (1981). The sickness impact profile: Development and final version of a Health Status Measure. Medical Care, 19(8), 787–806.

    Article  PubMed  Google Scholar 

  • Bernatsky, S., Dobkin, P. L., De Civita, M., Kang, H., & Penrod, P. (2005). Comorbidity and physician use in fibromyalgia. Swiss Medical Weekly, 135, 76–81.

    PubMed  Google Scholar 

  • Burckhardt, C. S., Clark, S. R., & Bennett, R. M. (1991). The Fibromyalgia Impact Questionnaire: Development and validation. Journal of Rheumatology, 18, 728–733.

    PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.

    Google Scholar 

  • Da Costa, D., Abrahamowicz, M., Lowensteyn, I., Bernatsky, S., Dritsa, M., Fitzcharles, M. A., et al. (2005). Arandomized clinical trial of an individualized home-based exercise program for women with fibromyalgia. Rheumatology, 44, 1422–1427.

    Article  PubMed  Google Scholar 

  • Derogatis, L. R. (1994). SCL-90-R: Administration, scoring and procedures manual. Minneapolis, MN: Clinical Psychometric Research.

    Google Scholar 

  • Dobkin, P. L., De Civita, M., Abrahamowicz, M., Bernatsky, S., Schulz, J., Sewitch, M. J., et al. (2003). Patient-physician discordance in fibromyalgia. Journal of Rheumatology, 30, 1326–1334.

    PubMed  Google Scholar 

  • Endler, N. S., & Parker, J. D. A. (1990). Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology, 58, 844–854.

    Article  PubMed  Google Scholar 

  • Endler, N. S., & Parker, J. D. A. (2000). Coping With Health Injuries and Problems (CHIP). (Manual) Toronto, Ontario, Canada: Multi-Health Systems Inc.

    Google Scholar 

  • Endler, N. S., Parker, J. D. A., & Summerfeldt, L. J. (1998). Coping with health problems: Developing a reliable and valid multidimensional measure. Psychological Assessment, 10, 195–205.

    Article  Google Scholar 

  • Goldenberg, D. L. (1999). Fibromyalgia syndrome a decade later: What have we learned? Archives of Internal Medecine, 159, 777–785.

    Article  Google Scholar 

  • Goldenberg, D. L., Mossey, C., & Schmid, C. H. (1995). A model to assess severity and impact of fibromyalgia. Journal of Rheumatology, 22, 2313–2318.

    PubMed  Google Scholar 

  • Granges, G., Zilko, P., & Littlejohn, G. O. (1994). Fibromyalgia syndrome: assessment of the severity of the condition 2 years after diagnosis. Journal of Rheumatology, 21, 523–529.

    PubMed  Google Scholar 

  • Hadjistavropoulos, H. D., Asmundson, J. G., & Norton, G. R. (1999). Validation of the Coping with Health, Injuries, and Problems Scale in a chronic pain sample. Clinical Journal of Pain, 15, 41–49.

    Article  PubMed  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Dell.

    Google Scholar 

  • Martin, M. Y., Bradley, L. A., Alexander, R. W., Alarcon, G. S., Triana-Alexander, M., Aaron, L. A., et al. (1996). Coping strategies predict disability in patients with primary fibromyalgia. Pain, 68, 45–53.

    Article  PubMed  Google Scholar 

  • Martinez, J. E., Ferraz, M. B., Sato, E. I., & Atra E. (2002). Fibromyalgia versus rheumatoid arthritis: A longitudinal comparison of the quality of life. Journal of Rheumatology, 22, 270–274.

    Google Scholar 

  • Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277–299.

    Article  PubMed  Google Scholar 

  • Nicassio, P. M., Radojevic, V., Eisman, M. H., Chuman, C., Choenfeld-Smith, K., & Krall, T. (1997). A comparison of behavioral and educational interventions for fibromyalgia. Journal of Rheumatology, 24, 2000–2006.

    PubMed  Google Scholar 

  • Nicassio, P. M., Shoenfeld-Smith, K., Radojevic, V., & Schuman, C. (1995). Pain coping mechanisms in Fibromyalgia: Relationship to pain and functional outcomes. Journal of Rheumatology, 22, 1552–1558.

    PubMed  Google Scholar 

  • Poyhia, R., Da Costa, D., & Fitzcharles, M. A. (2001). Pain and pain relief in fibromyalgia patients followed for 3 years. Arthritis Care and Research, 45, 355–361.

    Article  PubMed  Google Scholar 

  • Reading, A. E. (1983). The McGill Pain Questionnaire: An appraisal. In R. Melzack (Ed.), Pain measurement and assessment (pp. 55–61). New York: Raven.

    Google Scholar 

  • Sewitch, M. J., Abrahamowicz, M., Dobkin, P. L., & Tamblyn, R. (2003). Measuring differences between patients’ and physicians’ perceptions: The Patient-Physician Discordance Scale. Journal of Behavioral Medicine, 26, 245–264.

    Article  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics (3rd ed.). New York: HapperCollins.

    Google Scholar 

  • Walker, E. A., Keegan, D., Gardner, G., Sullivan, M. P., Katon, W. J., & Bertakis, K. D. (1997). Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: 1. Psychiatric diagnoses and functional disability. Psychosomatic Medicine, 59, 565–572.

    PubMed  Google Scholar 

  • White, K. P., Harth, M., Speechley, M., & Ostbye, T. (1999). Testing an instrument of screen for fibromyalgia syndrome in general population studies: The London Fibromyalgia Epidemiology Study Screening Questionnaire. Journal of Rheumatology, 26, 880–884.

    PubMed  Google Scholar 

  • White, K. P., Speechley, M., Harth, M., & Ostbye, T. (1999). Comparing self-reported function and work disability in 100 community cases of fibromyalgia syndrome versus controls in London, Ontario. Arthritis & Rheumatism, 42, 76–83.

    Article  Google Scholar 

  • Wolfe, F., Anderson, J. P., Harkness, D., Bennett, R. M., Caro, X. J., Goldenberg, D. L., et al. (1997). A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia. Arthritis & Rheumatism, 40, 1560–1570.

    Article  Google Scholar 

  • World Health Organization. (2006). ICIDH—2: International classification of functioning and disability. Retrieved April 17, 2006 from http://www.who/int/classification/icf/en/

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Patricia L. Dobkin.

Additional information

This study was made possible by funds received from The Canadian Arthritis Society. Salary support for Patricia L. Dobkin was provided by Fonds de la recherche en santé du Québec (FRSQ) as a Senior Scientist; Mirella De Civita by a Postdoctoral Fellowship from the Canadian Institutes of Health Research (CIHR); Michal Abrahamowicz as a James McGill Professor; Sasha Bernatsky from the CIHR as a Postgraduate Fellow. The following physicians examined patients: Drs. Martin Cohen, Mary-Ann Fitzcharles, Michael Starr, Jan Schulz, Murray Baron, Pierre Dagenais, Suzanne Mercille, Anne St-Pierre, Sasha Bernatsky and Harbhajan Kang. We thank Ms. Natalie Dayan who served as the Project Coordinator, Ms. Roxane du Berger for her assistance with statistical analyses, and Ms. Tammy Allan for excellent secretarial support. We also thank the women with FM who agreed to participate in the study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dobkin, P.L., Civita, M.D., Abrahamowicz, M. et al. Predictors of health status in women with fibromyalgia: A prospective study. Int. J. Behav. Med. 13, 101–108 (2006). https://doi.org/10.1207/s15327558ijbm1302_1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1207/s15327558ijbm1302_1

Key words

Navigation