Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: A Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia

Wolfe, Frederick; Clauw, Daniel J.; Fitzcharles, Mary Ann; Goldenberg, Don L.; Haüser, Winfried; Katz, Robert S.; Mease, Philip J.; Russell, Anthony S.; Russell, I. Jon; Winfield, John B.

doi:10.3899/jrheum.100594

Cited by 1,271 publications

(1,198 citation statements)

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“…Widespread pain, which can be documented with pain diagrams, has been associated with psychologic distress [24,28,33,34]. These observations suggest that a body pain diagram might be associated with psychologic distress including catastrophizing and depression.…”

Section: Discussionmentioning

confidence: 92%

“…The baseline questionnaire included a body pain diagram [6] based on the Widespread Pain Index [33,34], with a list of 19 checkboxes corresponding to anatomic areas throughout the body that study participants were asked to check if they had any current pain at those sites. We delineated six different body regions using the 19 sites on the body pain diagram.…”

Section: Methodsmentioning

confidence: 99%

“…Because widespread pain has been associated with poor outcome in various diseases [4,12,13,24,28], and because widespread pain is often clinically understood as a sign of psychologic distress [15,19,23,27,28,33,34], we posited that widespread pain, as documented on a pain diagram, would be associated with catastrophizing and depression and poor functional status.…”

Section: Introductionmentioning

confidence: 99%

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Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Dave

Selzer

Losina

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Greater levels of self-reported pain, pain catastrophizing, and depression have been shown to be associated with persistent pain and functional limitation after surgeries such as TKA. It would be useful for clinicians to be able to measure these factors efficiently. Questions/purposes We asked: (1) What is the association of whole-body pain with osteoarthritis (OA)-related knee pain, function, pain catastrophizing, and mental health? (2) What is the sensitivity and specificity for different cutoffs for body pain diagram region categories in relation to pain catastrophizing? Methods Patients (n = 267) with knee OA undergoing elective TKA at one academic center and two community orthopaedic centers were enrolled before surgery in a prospective cohort study. Questionnaires included the WOMAC Pain and Function Scales, Pain Catastrophizing Scale (PCS), Mental Health Inventory-5 (MHI-5), and a pain body diagram. The diagram documents pain in 19 anatomic areas. Based on the distribution of the anatomic areas, we established six different body regions. Our analyses excluded the index (surgically treated) knee. Linear regression was used to evaluate the association between the total number of nonindex painful sites on the whole-body pain diagram and measures of OA-related pain and function, mental health, and pain catastrophizing. Generalized linear regression was used to evaluate the association between the number of painful nonindex body regions (categorized as 0; 1-2; or 3-6) with our measures of interest. All models were adjusted for age, sex, and number of comorbid conditions. The cohort included 63% females and the mean age was 66 years (SD, 9 years). With removal of the index knee, the median pain diagram score was 2 (25 th , 75 th percentiles, 1, 4) with a range of 0 to 15. The median number of painful body regions was 2 (25 th , 75 th percentiles, 1, 3). Results After adjusting for age, sex, and number of comorbid conditions, we found modest associations between painful body region categories and mean scores for WOMAC physical function (r = 0.22, p \ 0.001), WOMAC pain (r = 0.20, p = 0.001), MHI-5 (r = À0.31, p\ 0.001), and PCS (r = 0.27, p \ 0.001). A nonindex body pain region score greater than 0 had 100% (95% CI, 75%-100%) sensitivity for a pain catastrophizing score greater than 30 but a specificity of just 23% (95% CI, 18%-29%) . A score of 3 or greater had greater specificity (73%; 95% CI, 66%-79%) but lower sensitivity (53%; 95% CI, 27%-78%). Conclusions We found modest associations between the number of painful sites on a whole-body pain diagram and the number of painful body regions and measures of OArelated pain, function, pain catastrophizing, and mental health. Patients with higher self-reported body pain region scores might benefit from further evaluation for depression and pain catastrophizing. Level of Evidence Level III, therapeutic study.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Dave

Selzer

Losina

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…We included patients of any age with a clinical diagnosis of FMS by any published, recognized and standardized criteria (Smythe, 1981;Yunus et al, 1981;Wolfe et al, 1990Wolfe et al, , 2010Wolfe et al, , 2011.…”

Section: Criteria For Considering Studies For This Reviewmentioning

confidence: 99%

Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta‐analysis of randomized controlled trials

Bernardy

Klose

Welsch

et al. 2017

European Journal of Pain

173

122

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This updated systematic review aimed at evaluating the efficacy, acceptability and safety of cognitive behavioural therapies (CBTs) in fibromyalgia syndrome (FMS). Clinicaltrials.gov, Cochrane Library, MEDLINE, PsycINFO and SCOPUS were searched from September 2013 to May 2017. Randomized controlled trials (RCTs) comparing CBTs with controls were analysed. Primary outcomes were ≥50% pain relief, ≥20% improvement of health‐related quality of life (HRQoL), negative mood, fatigue, disability, acceptability and safety at end of therapy and at 6 months follow‐up. Effects were summarized by a random effects model using risk differences (RD) or standardized mean differences (SMD) with 95% confidence intervals (CI). 29 RCTs with 2509 subjects were included. CBTs were superior to controls (waiting list, attention control, treatment as usual, other active non‐pharmacological therapies) in pain relief of 50% or greater (RD 0.05 [95% CI 0.02–0.07] (high‐quality evidence), improvement of HRQoL of 20% or greater (RD 0.13 [95% CI 0.00–0.26], (moderate quality evidence), and in reducing negative mood (SMD −0.43 [95% CI −0.62 to −0.24]) (high‐quality evidence), disability (SMD −0.30 [95% CI −0.52 to −0.08]) (high‐quality evidence) and fatigue (SMD – 0–27 [95% CI −0.50 to −0.03]) (high‐quality evidence). There were no statistically significant differences between CBTs and controls in acceptability and safety (high‐quality evidence). The update did not change the major findings of the previous review. CBTs provided a clinically relevant benefit over control interventions in reducing some key symptoms of FMS and disability at the end of treatment. Significance This updated systematic review with meta‐analysis on cognitive behavioural therapies (CBTs) including acceptance‐based CBTs endorse the efficacy and tolerability of CBTs in reducing key symptoms and disability in FMS in the short‐ and long‐term if compared to waiting list, treatment as usual, attention controls and active non‐pharmacological therapies. CBTs did not differ in efficacy except superiority for coping with pain and tolerability from recommended drug therapy (pregabalin and/or duloxetine).

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“…6 The American College of Rheumatology (ACR) proposed new diagnostic criteria in 2010, examined in a 31-point questionnaire. 7 These criteria were subsequently modified in 2011, 8 and replaced the original criteria published in 1990. 9 Recent systematic reviews support the use of pregabalin to treat pain, sleep problems, fatigue and anxiety in patients with fibromyalgia.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for fibromyalgia in primary care: a randomised controlled trial

Vas¹,

Santos-Rey²,

Navarro-Pablo

et al. 2017

Deutsche Zeitschrift für Akupunktur

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Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: A Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia

Cited by 1,271 publications

References 30 publications

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta‐analysis of randomized controlled trials

Acupuncture for fibromyalgia in primary care: a randomised controlled trial

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